Immediate oral dissolution therapy: Incorrect

Oral dissolution therapy using Urosodiol or Chenodiol is generally reserved for patients with chronic cholecystitis who have stones that are less than 5mm in size and are devoid of calcium. In addition, there must be no obstruction of the cystic duct. The oral dissolution agent reduces cholesterol saturation of bile by inhibiting cholesterol secretion. Only about 15% of patients with gallstones are suitable for oral dissolution therapy. Dissolution of the stones is achieved in 50% of these patients within 2 years of treatment. However, a recurrence rate of 50% within 5yrs of treatment is common.

Mrs. Jones is having an episode of acute cholecystitis. Because oral dissolution therapy is a long-term treatment, it is not suitable in this case. Although Mrs. Jones may have benefited from oral dissolution therapy before, this form of treatment would not be appropriate for the initial management of an acute episode of cholecystitis.

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