DMSO PREPARATION AS A DIRECT SOLUBILIZER OF CALCIUM BILIRUBINATE STONES

Despite considerable progress in operative techniques, biliary surgeon s continue to encounter difficulties when treating patients with intra hepatic gallstones. We have experienced a significant number of patien ts in whom complete stone removal was impossible during an operation d ue to the anatomical complexity of intrahepatic bile ducts, and the va riety in the size and hardness of the stones. Under such circumstances , the application of a direct solubilizer capable of dissolving intrah epatic calcium bilirubinate stones, might be a possible alternative. U p to now, however, only calcium chelating agents have been used for re moving calcium from calcium bilirubinate stones, and they are not alwa ys effective. As a promising solution to this problem, we have now dev eloped a direct solubilizer for bilirubin complexes - a dimethyl sulfo xide (DMSO) preparation. DMSO is a well-known bipolar nonprotonic solv ent. We prepared solutions of DMSO and performed toxicological studies by administering this preparation to rats and dogs. Biochemical indic es of liver and renal function remained unchanged after 7-28 days of D MSO administration. Nor were there any histological changes in the DMS O-treated animals on systemic survey of various organs. On comparing t he in vitro capability for solubilizing calcium bilirubinate stones, t he DMSO preparation was consistently superior to a calcium chelating a gent alone. The combination of a chelating agent with DMSO had the hig hest solubilizing capacity.