Biliary sludge as a pre-stone stage of cholelithiasis. Clinical cases of Himecromone application

The paper reviews the current literature on biliary sludge (BS), a pre-stone stage of cholelithiasis. Risk factors, unresolved issues of primary prevention of cholelithiasis, etiopathogenetic mechanisms, methods of diagnosis and treatment of functional biliary disorders and BS are considered. Clinical case reports in BS patients demonstrate efficacy of combined therapy (Ursodeoxycholic acid + Himecromone, a selective antispasmodic). Both patients had risk factors for BS (genetic predisposition, pregnancy, and low-calorie diet). Based on the literature data and the authors' own experience, the authors concluded that timely diagnosis and treatment of functional biliary disorder and BS are important to prevent cholelithiasis. KEYWORDS: biliary sludge, biliary dysfunctions, ursodeoxycholic acid, himecromone. FOR CITATION: Selezneva E.Ya., Embutnieks Yu.V., Bernaz M.V., Mechetina T.A., Koricheva E.S. Biliary sludge as a pre-stone stage of cholelithiasis. Clinical cases of Himecromone application. Russian Medical Inquiry. 2025;9(5):291–296 (in Russ.). DOI: 10.32364/2587-6821- 2025-9-5-6