Skip to main content
Gut logoLink to Gut
. 1988 Feb;29(2):143–145. doi: 10.1136/gut.29.2.143

Choledocholithiasis--in vivo stone dissolution using methyl tertiary butyl ether (MTBE).

W R Murray 1, G LaFerla 1, G M Fullarton 1
PMCID: PMC1433287  PMID: 3345924

Abstract

We report a series of 10 elderly patients with large bile duct calculi refractory to standard endoscopic extraction techniques who were treated by gall stone dissolution using methyl tertiary butyl ether (MTBE) instilled through a nasobiliary catheter. In eight patients complete bile duct clearance was achieved after an average of eight hours MTBE instillation. In two patients gall stone size did not change. Both underwent operative gall stone removal and subsequent stone analysis showed low cholesterol content, which is unlikely to respond to MTBE. Apart from occasional transient nausea and drowsiness, no adverse reactions were noted. Methyl tertiary butyl ether appears to be a powerful in vivo gall stone dissolution agent which, from preliminary studies, is not associated with serious toxicity.

Full text

PDF
143

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Allen M. J., Borody T. J., Bugliosi T. F., May G. R., LaRusso N. F., Thistle J. L. Rapid dissolution of gallstones by methyl tert-butyl ether. Preliminary observations. N Engl J Med. 1985 Jan 24;312(4):217–220. doi: 10.1056/NEJM198501243120406. [DOI] [PubMed] [Google Scholar]
  2. Allen M. J., Borody T. J., Thistle J. L. In vitro dissolution of cholesterol gallstones. A study of factors influencing rate and a comparison of solvents. Gastroenterology. 1985 Nov;89(5):1097–1103. doi: 10.1016/0016-5085(85)90215-x. [DOI] [PubMed] [Google Scholar]
  3. BEST R. R., RASMUSSEN J. A., WILSON C. E. An evaluation of solutions for fragmentation and dissolution of gallstones and their effect on liver and ductal tissue. Ann Surg. 1953 Oct;138(4):570–581. doi: 10.1097/00000658-195310000-00010. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Fromm H. Gallstone dissolution therapy. Current status and future prospects. Gastroenterology. 1986 Dec;91(6):1560–1567. [PubMed] [Google Scholar]
  5. Harrison J., Morris D. L., Haynes J., Hitchcock A., Womack C., Wherry D. C. Electrohydraulic lithotripsy of gall stones--in vitro and animal studies. Gut. 1987 Mar;28(3):267–271. doi: 10.1136/gut.28.3.267. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. LaFerla G., McCulloch A., Murray W. R. In-vivo chemical choledocholitholysis using MTBE. Br J Hosp Med. 1987 Feb;37(2):163–164. [PubMed] [Google Scholar]
  7. Martin D. F., Tweedle D. E. Endoscopic management of common duct stones without cholecystectomy. Br J Surg. 1987 Mar;74(3):209–211. doi: 10.1002/bjs.1800740320. [DOI] [PubMed] [Google Scholar]
  8. Moss J. G., Saunders J. H., Wild S. R. Endoscopic papillotomy for removal of common bile duct stones without cholecystectomy. J R Coll Surg Edinb. 1985 Apr;30(2):112–114. [PubMed] [Google Scholar]
  9. Palmer K. R., Hofmann A. F. Intraductal mono-octanoin for the direct dissolution of bile duct stones: experience in 343 patients. Gut. 1986 Feb;27(2):196–202. doi: 10.1136/gut.27.2.196. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Vellacott K. D., Powell P. H. Exploration of the common bile duct: a comparative study. Br J Surg. 1979 Jun;66(6):389–391. doi: 10.1002/bjs.1800660605. [DOI] [PubMed] [Google Scholar]

Articles from Gut are provided here courtesy of BMJ Publishing Group

RESOURCES