[Cholecystolithiasis and choledocholithiasis cured by methyl tert butyl ether (MTBE) combined with EST]

A 70-year old male patient was admitted to hospital with fever and right upper quadrant pain. Ultrasonography and cholecystography revealed acute cholecystitis associated with multiple stones not only in the gallbladder but also in the common bile duct. Percutaneous trans-gallbladder drainage (PTGBD) was performed because of his persisting complaints and severe inflammatory change of the gallbladder. Operation was not considered due to his cardiac problem, so we tried direct dissolution treatment of the gallstones by using Methyl tert butyl ether (MTBE) through the percutaneous transhepatic catheter. Following maximal aspiration of the gallbladder contents, same amount of MTBE was infused into and the patient was kept in the right-side-down position for an hour. After 30 times of MTBE treatment, all stones in the gallbladder were thoroughly dissolved without any side effect. A residual stone in the common bile duct was easily taken out by endoscopic sphincterotomy.