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Manual and automatic gallstone dissolution with methyl tert-butyl ether

U Leuschner1, A Hellstern, A Ansell

  • 1Department of Gastroenterology, Johann Wolfgang Goethe Universität, Frankfurt am Main, Germany.

Digestive Diseases and Sciences
|June 1, 1994
PubMed
Summary

Methyl tert-butyl ether effectively dissolves cholesterol gallstones. Automatic pump therapy offers similar stone dissolution rates to manual methods but significantly reduces nursing time and is not associated with increased side effects.

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Direct dissolution of gallbladder stones with methyl tert-butyl ether (MTBE).

Revista de investigacion clinica; organo del Hospital de Enfermedades de la Nutricion·2009

Area of Science:

  • Gastroenterology
  • Hepatology
  • Minimally Invasive Surgery

Background:

  • Cholesterol gallstones are a common ailment.
  • Dissolving gallstones in situ offers a less invasive treatment option compared to surgery.
  • Methyl tert-butyl ether (MTBE) has shown promise for gallstone dissolution.

Purpose of the Study:

  • To evaluate the efficacy of MTBE for cholesterol gallstone dissolution in a large patient cohort.
  • To compare manual (nurse-administered) versus automatic pump delivery of MTBE.
  • To assess treatment outcomes, including stone-free rates, treatment duration, and side effects.

Main Methods:

  • Gallbladder puncture and MTBE instillation were performed in 228 patients.
  • Patients were randomized into manual (hand-syringed) or automatic pump (Baxter) treatment groups (42 patients each).

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  • Stone dissolution, residual sludge, treatment time, and adverse events were recorded.

    • Main Results:

    • Gallbladder puncture success rate was 99% (228/228).
    • 91% (211/228) of patients were stone-free after 9 hours; 68% (144/211) were discharged on day 4.
    • Dissolution rates were comparable between manual and automatic groups (96%), with no significant difference in sludge presence or side effects. Automatic therapy reduced nursing time by 70%.

    Conclusions:

    • MTBE is an effective treatment for cholesterol gallstone dissolution.
    • Automatic pump delivery is as effective as manual administration, with comparable safety profiles.
    • Automatic therapy significantly improves nursing efficiency without compromising patient outcomes.