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Related Experiment Videos

Gallstone dissolution in man using cholic acid and lecithin.

J Toouli, P Jablonski, J M Watts

    Lancet (London, England)
    |December 6, 1975
    PubMed
    Summary
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    Oral cholic acid and purified soya-bean lecithin treatment dissolved or reduced gallstones in some patients. Bile became less lithogenic, with altered bile acid profiles, suggesting a potential therapeutic approach for gallstones.

    Area of Science:

    • Gastroenterology and Hepatology
    • Biliary System Physiology
    • Pharmacological Treatment of Gallstones

    Background:

    • Radiolucent stones in the gallbladder and biliary tree pose a clinical challenge.
    • Current treatment options for gallstones may be invasive or have limitations.
    • Understanding the impact of therapeutic agents on bile composition is crucial for gallstone management.

    Purpose of the Study:

    • To evaluate the efficacy of oral cholic acid and purified soya-bean lecithin in treating radiolucent gallstones.
    • To assess the effect of this treatment on bile composition, including cholesterol, bile acid, and phospholipid levels.
    • To analyze changes in the lithogenic index and specific bile acid concentrations.

    Main Methods:

    • Nine patients with radiolucent gallstones (gallbladder and biliary tree) received oral cholic acid and purified soya-bean lecithin for six months.

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  • Treatment outcomes were assessed by stone disappearance or size reduction.
  • Fasting bile samples from five patients were analyzed for cholesterol, bile acid, and phospholipid content before and during treatment.

    • Main Results:

    • Gallstones disappeared in two patients and were reduced in size in one patient.
    • The lithogenic index of bile significantly decreased in all five patients whose bile was analyzed.
    • Treatment led to increased biliary deoxycholic acid and decreased chenodeoxycholic acid concentrations.

    Conclusions:

    • Oral cholic acid and purified soya-bean lecithin demonstrate potential in dissolving or reducing radiolucent gallstones.
    • The treatment favorably alters bile composition, reducing its lithogenicity.
    • These findings suggest a non-invasive therapeutic strategy for managing certain types of gallstones.