The preventive effect of vitamin E on gallstone formation. (3) . A study of the biliary lipids in patients with gallstones
Saito, T.; Tanimura, H.
Nihon Geka Hokan. Archiv für Japanische Chirurgie 56(3): 276-288
1987
ISSN/ISBN: 0003-9152 PMID: 3689084 Document Number: 300235
An .alpha.-tocopherol soft capsule (100 mg of d-.alpha.-tocopherol) was given orally to 12 patients with gallstones. The dosage was 6 capsules daily (200 mg t.i.d.) in 10 of the patients and 1 capsule daily (100 mg. after breakfast) in the other two patients, and these dosages were maintained for 4 consecutive days. In patients receiving 600 mg daily and in whom the T-tube was kept closed all day except for 5 minutes in the early morning (the concentration study group), showed serum .alpha.-tocopherol levels of 27-43 .mu.g/ml. In patients whose bile was retained in the bag for 24 hours (the excretion study group), the serum .alpha.-tocopherol level remained at 12.6 .mu.g/ml. In five patients with cholesterol gallstones, the 600 mg/day .alpha.-tocopherol administration reduced biliary cholesterol levels and increased glycine-conjugated bile acids. A corresponding improvement of the lithogenic index was observed in all five patients. On the other hand, in the two patients of excretion group whose T-tubes were not closed at the beginning of this study, in the two patients with bilirubin stones, and in a patient who underwent total gastrectomy, the above effects of .alpha.-tocopherol were not observed, despite the daily dose of 600 mg. In the two patients receiving 100 mg of .alpha.-tocopherol daily, these effects were also not observed. It was suggested that .alpha.-tocopherol may be clinically useful in mono-therapy or combination therapy of gallstone dissolytion with CDCA and/or UDCA, recommended for prophylaxis of recurrence after complete dissolution. However, low doses of .alpha.-tocopherol in patients with cholesterol stones and patients with other stones were not effective.