NONOPERATIVE REMOVAL OF RETAINED COMMON DUCT STONES AFTER BILIARY SURGERY WITH CLOFIBRATE

We present the first clinical case of multiple residual choledocholithiasis successfully treated with trans-T-tube clofibrate perfusions, to appear in the world's medical literature. Perfusions were carried out with a solution consisting of: 1500 mg of clofibrate, 4 mg of dexamethasone, in 250 ml of isotonic saline solution; the first previously dissolved in 10 ml of ethyl alcohol. The perfusions were consistently carried out at 8-h intervals. After 1 week, a follow-up cholangiogram showed only stone remaining in the terminal portion of the common bile duct. Clofibrate irrigations were continued and 5 days later a new cholangiogram showed and absolutely permeable biliary tract through which the contrast passed freely into the duodenum. This case clinically confirms our previous in vitro studies, which demonstrated the extraordinary litholitic capacity of clofibrate. © 1979.