Direct dissolution of gallstones with methyl tert-butyl ether (MTBE) via endoscopic transpapillary catheterization in the gallbladder (ETCG)

In a pilot study of direct dissolution therapy of gallstones with methyl tert-butyl ether (MTBE), endoscopic transpapillary catheterization in the gallbladder (ETCG) was performed. Complete dissolution was seen in 8 out of 12 (66%) patients and partial dissolution was seen in 2 (16%) patients. In on...

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Bibliographic Details
Published in:Journal of gastroenterology 1994-08, Vol.29 (4), p.486-494
Main Authors: Uchida, N, Nakatsu, T, Hirabayashi, S, Minami, A, Fukuma, H, Ezaki, T, Morshed, S A, Fuke, C, Ameno, K, Ijiri, I
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Animals
Catheterization - methods
Cholangiopancreatography, Endoscopic Retrograde
Cholelithiasis - therapy
Combined Modality Therapy
Endoscopy, Digestive System
Ethers - administration & dosage
Ethers - therapeutic use
Female
Gallbladder
Humans
Lithotripsy
Male
Methyl Ethers
Middle Aged
Pilot Projects
Rabbits
Solvents
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Summary:In a pilot study of direct dissolution therapy of gallstones with methyl tert-butyl ether (MTBE), endoscopic transpapillary catheterization in the gallbladder (ETCG) was performed. Complete dissolution was seen in 8 out of 12 (66%) patients and partial dissolution was seen in 2 (16%) patients. In one of the 8 complete dissolution patients, combined extracorporeal shock wave lithotripsy (ESWL) and dissolution therapy was carried out successfully. These 8 patients were followed up for 12-20 months with regular ultrasonography. During this period, 1 patient underwent laparoscopic cholecystectomy due to stone recurrence. Thickening of the gallbladder wall was seen in 2 patients, but there were no other complications. Using Tsuchiya's classification based on ultrasound, complete dissolution was seen in type Ia stones. This pilot study suggests that the direct dissolution of gallstones with MTBE via ETCG might be a useful and safe non-invasive treatment in patients with cholesterol stones in preserved gallbladders.
ISSN:0944-1174
1435-5922
DOI:10.1007/BF02361248