Targets for current pharmacologic therapy in cholesterol gallstone disease

Agostino Di Ciaula, David Q.H. Wang, Helen H. Wang, Leonilde Bonfrate, Piero Portincasa

Research output: Contribution to journalReview article

38 Citations (Scopus)

Abstract

Gallstone disease is a frequent condition throughout the world and, cholesterol stones are the most frequent form in Western countries. The standard treatment of symptomatic gallstone subjects is laparoscopic cholecystectomy. The selection of patients amenable for nonsurgical, medical therapy is of key importance; a careful analysis should consider the natural history of the disease and the overall costs of therapy. Only patients with mild symptoms and small, uncalcified cholesterol gallstones in a functioning gallbladder with a patent cystic duct are considered for oral litholysis by hydrophilic ursodeoxycholic acid, in the hope of achieving cholesterol desaturation of bile and progressive stone dissolution. Recent studies have raised the possibility that cholesterol-lowering agents that inhibit hepatic cholesterol synthesis (statins) or intestinal cholesterol absorption (ezetimibe), or drugs acting on specific nuclear receptors involved in cholesterol and bile acid homeostasis, may offer, alone or in combination, additional medical therapeutic tools for treating cholesterol gallstones. Recent perspectives on medical treatment of cholesterol gallstone disease are discussed in this article.

Original languageEnglish (US)
JournalGastroenterology Clinics of North America
Volume39
Issue number2
DOIs
StatePublished - Jun 1 2010
Externally publishedYes

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Gallstones
Cholesterol
Therapeutics
Cystic Duct
Hydroxymethylglutaryl-CoA Reductase Inhibitors
Ursodeoxycholic Acid
Cost of Illness
Laparoscopic Cholecystectomy
Intestinal Absorption
Cytoplasmic and Nuclear Receptors
Gallbladder
Bile Acids and Salts
Bile
Patient Selection
Homeostasis
Liver

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Targets for current pharmacologic therapy in cholesterol gallstone disease. / Di Ciaula, Agostino; Wang, David Q.H.; Wang, Helen H.; Bonfrate, Leonilde; Portincasa, Piero.

In: Gastroenterology Clinics of North America, Vol. 39, No. 2, 01.06.2010.

Research output: Contribution to journalReview article

Di Ciaula, Agostino ; Wang, David Q.H. ; Wang, Helen H. ; Bonfrate, Leonilde ; Portincasa, Piero. / Targets for current pharmacologic therapy in cholesterol gallstone disease. In: Gastroenterology Clinics of North America. 2010 ; Vol. 39, No. 2.
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