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ARTICLE |

Solubility of Cholesterol and Gallstones in Metabolic Material

CHARLES G. JOHNSTON, M.D.; FUMIO NAKAYAMA, M.D.
AMA Arch Surg. 1957;75(3):436-442. doi:10.1001/archsurg.1957.01280150126013.
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The solution of gallstones within the extrahepatic biliary tree has been repeatedly attempted, without generally accepted success. Organic solvents have been used to remove retained stones after choledochostomy, but this method has not been widely accepted because of lack of uniform success and because of the irritating properties of the solvent. Best1,2 recommended flushing of the stones by increasing bile flow with dehydrocholic acid N. F. (Decholin), together with drugs to relax the sphincter, but did not intimate that by this procedure the stones became any smaller. Obviously, only small stones could be expected to respond to this treatment because of the small diameter of the duct even when the sphincter is relaxed.

Naunyn,3 in 1892, stated that human gallstones placed in the gallbladder of the dog disappeared after a few months. This has been repeatedly corroborated,4-12 and it seems clear that the stone disappears because of

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