In vitro cholesterol gallstone dissolution: comparison of methyl tert-butyl ether with three new ester solvents

The in vitro effectiveness of three new cholesterol gallstone solvents that have a potential for clinical use--ethyl propionate, isopropyl acetate, and n-propyl acetate--was compared with that of the well-known cholesterol solvent methyl tert-butyl ether (MTBE). Ten sets of matched gallstones were initially weighed, imaged with radiography and computed tomography (CT), and analyzed for content. One stone from each set was incubated in one of the four solvents at 37 degrees C. Solvents were changed at 30-minute intervals. The study was stopped either when the stones were completely dissolved or at the end of 7 hours. Any residual fragments were weighed, reimaged, and reanalyzed for content. There were no statistical differences between dissolution times of the stones in MTBE compared with those in the three new solvents. Ethyl propionate and n-propyl acetate appear to be as efficacious as MTBE in dissolving cholesterol stones and could be attractive alternatives for gallstone chemolysis.