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Laparoscopic cholecystectomy using methyl tert-butyl ether: preliminary results
Surgical Laparoscopy & Endoscopy
|February 1, 1994
Summary
Methyl tert-butyl ether (MTBE) effectively softens large gallstones during laparoscopic cholecystectomy. This method facilitates gallbladder extraction, proving to be a cheap and fast solution for complex cases.
Area of Science:
- Surgical Innovation
- Gastroenterology
- Medical Chemistry
Background:
- Laparoscopic cholecystectomy is standard for gallstones.
- Large gallstones (>30 mm) pose extraction challenges.
- Standard extraction may require enlarging the port or conversion to open surgery.
Purpose of the Study:
- To evaluate methyl tert-butyl ether (MTBE) for softening large gallstones.
- To assess the feasibility of MTBE use during laparoscopic cholecystectomy.
- To determine if MTBE aids gallbladder extraction without port enlargement.
Main Methods:
- Five patients with large gallstones underwent laparoscopic cholecystectomy.
- MTBE was infused via a catheter into the gallbladder neck.
- Solvent was injected, aspirated, and reinjected until stones softened.
- Softened stones were removed using forceps or aspirator.
Main Results:
- Gallbladder extraction was challenging due to large stone size.
- MTBE infusion successfully softened stones in all patients.
- Mean procedure time for MTBE application was 7.7 +/- 1.57 minutes.
- Extraction was achieved without enlarging the 10-mm umbilical port.
Conclusions:
- MTBE is a useful adjunct for gallbladder extraction in laparoscopic cholecystectomy.
- It offers a cheap and fast method to manage large gallstones.
- Consider MTBE for cases with symptomatic, large gallstones to facilitate extraction.