In vitro comparison of different gall stone dissolution solvents

Area of Science:

• Gastroenterology
• Biochemistry
• Medical Devices

Background:

• Extracorporeal shockwave lithotripsy (ESWL) is used for gall bladder stones but leaves residual fragments.
• These fragments often require chemical dissolution for complete clearance.

Purpose of the Study:

• To compare the in vitro dissolving capacity of four chemical solvents on human gall stones.
• To identify the most effective solvent for residual gall stone fragments post-ESWL.

Main Methods:

• Human gall stones were analyzed for cholesterol, calcium, and bilirubin content.
• Four solvents were tested: methyl tert-butyl ether (MTBE), mono-octanoin, limonene, and a limonene/mono-octanoin mixture.
• Dissolution rates of cholesterol gall stones were measured in vitro.

Main Results:

• All tested solvents dissolved cholesterol gall stones, though some left debris.
• MTBE dissolved cholesterol gall stones 100 times faster than mono-octanoin and 10 times faster than limonene or the mixture.
• The limonene/mono-octanoin mixture showed similar efficacy to limonene alone.

Conclusions:

• Methyl tert-butyl ether (MTBE) is the most potent solvent for dissolving residual gall stone fragments.
• MTBE warrants further evaluation for clinical use after ESWL treatment of gall bladder stones.