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Gallstone recurrence after direct contact dissolution with methyl tert-butyl ether
J Pauletzki1, J Holl, M Sackmann
1Department of Medicine II, Klinikum Grosshadern, University of Munich, Germany.
Digestive Diseases and Sciences
|August 1, 1995
Summary
Gallstone recurrence is common after methyl tert-butyl ether dissolution therapy, with a high cumulative risk over four years. However, most patients remain symptom-free long-term.
Area of Science:
- Gastroenterology
- Hepatobiliary Surgery
Background:
- Gallstone dissolution therapy aims for non-invasive treatment.
- Recurrence rates after treatment require long-term evaluation.
Purpose of the Study:
- To assess the rate and characteristics of gallstone recurrence following direct contact dissolution with methyl tert-butyl ether (MTBE).
Main Methods:
- Prospective follow-up of 60 patients for up to 4.5 years post-MTBE treatment.
- Actuarial analysis used to determine cumulative recurrence risk.
- Characterization of recurrent stones and assessment of treatment outcomes.
Main Results:
- Twenty-eight of 60 patients (47%) developed recurrent gallstones.
- Cumulative recurrence risk reached 70% by four years.
- Recurrent stones were typically multiple and small; recurrence associated with biliary pain in two patients.
Conclusions:
- High rates of gallstone recurrence are expected after MTBE dissolution therapy for multiple stones.
- Recurrent stones were successfully treated in a majority of patients.
- Long-term follow-up indicates most patients remain free of biliary pain.