DISSOLUTION OF CHOLESTEROL GALLBLADDER STONES WITH METHYL TERT-BUTYL ETHER IN PATIENTS WITH INCREASED SURGICAL RISK

The safety and efficacy of methyl tert-butyl ether (MTBE) dissolution of cholesterol gallbladder stones were evaluated in 25 patients with i ncreased risk for surgery. Two patients were treated twice. The MTBE w as infused and aspirated manually through a percutaneous transhepatic catheter to the gallbladder. The placement of the catheter failed in t hree patients (11%). In 19 of 24 patients (79%) there was complete dis solution of stones after a mean treatment time of 12.2 h (range, 4.3-1 9.5 h). In five patients treatment was discontinued before complete di ssolution owing to technical problems or side effects. Side effects we re nausea, pain, vasovagal reaction, and fever. Fifteen patients were followed up for a mean of 15.7 months after dissolution. Stone recurre nce was found in eight patients, five of whom suffered symptomatic rel apse. We conclude that dissolution therapy with MTBE is a safe and ade quate alternative to surgery in selected high-risk patients.