Methyl-TER-butyl ether (MTBE) and endoscopic sphincterotomy. A possible solution for dissolving gallstones.

MTBE was instilled in 6 cases of lithiasis (1 intrahepatic, 5 giant common bile duct stones following EPT). The nasobiliary route (3 cases) and a percutaneous biliary drain (3 cases) were used for this purpose. Complete stone dissolution was achieved in four cases. In the other two, volume reduction was sufficient to allow spontaneous elimination after EPT. A full clinical recovery was obtained in all cases. Further investigation is required in cases of intrahepatic and common bile duct stones when their removal by EPT is not enough to lead to clinical resolution. Follow-up is indispensable.

[Clinical evaluation of chemical cholelitholysis using methyl tertiary butyl ether in lithiasis of the bile ducts]. / Valutazione clinica della colelitolisi chimica con MTBE nella litiasi delle vie biliari.

Personal experience is reported in the treatment of calculosis of the biliary ways using MTBE and injected through percutaneous biliary drainage catheters placed surgically or endoscopically in 11 patients in whom surgery appeared to be contraindicated or particularly dangerous. In 10 out of the 11 cases chemical cholelitholysis was successful and the technique is therefore proposed as a valid alternative to surgery in ductal cholelitholysis when sphincterotomy and endoscopic removal of the stones cannot cure the conditions.