title: The acceleration of gallstone destruction with synchronous biliary lithotripsy and contact dissolution in vitro using three cholesterol-solubilizing solvent.
abstract: In the first-known application of its kind, shockwave lithotripsy and contact-solvent dissolution of large, calcified gallstone burdens were performed simultaneously with three chemical solvents, each tested separately in an in vitro model, with the combined effects on gallstone eradication examined. Two solvents, ethyl propionate and isopropyl acetate, were chosen for their solubilizing ability and potentially high level of patient safety. The third solvent, a 70%:30% mixture of methyl tert-butyl ether (MTBE) and dimethyl sulfoxide (DMSO), was chosen for its known ability to accelerate the dissolution of calcium-containing gallstones. All stones were matched for size, weight, and number. Gallstone lithotripsy performed in ethyl propionate was significantly more effective (P less than .02) in the production of fragments less than 2 mm when compared with bile; lithotripsy with isopropyl acetate and the MTBE/DMSO mixture showed no statistically significant effect. Biliary lithotripsy performed in an ethyl propionate medium may enhance gallstone dissolution and the production of small fragments (diameter less than 2 mm).
authors.affiliation: Department of Radiological Sciences, University of California, Irvine, Orange 92668.
authors.forename: L S
authors.initials: LS
authors.lastname: Kannegieter
authors.forename: J C
authors.initials: JC
authors.lastname: Brandon
authors.forename: S K
authors.initials: SK
authors.lastname: Teplick
authors.forename: J A
authors.initials: JA
authors.lastname: Norris
authors.forename: M L
authors.initials: ML
authors.lastname: Baker
authors.forename: L S
authors.initials: LS
authors.lastname: Deutsch
authors.forename: R M
authors.initials: RM
authors.lastname: Friedenberg
mesh_terms: D000085:Acetates / Q000627:therapeutic use; D002769:Cholelithiasis / Q000628:therapy*; D002784:Cholesterol; D003131:Combined Modality Therapy; D004121:Dimethyl Sulfoxide / Q000627:therapeutic use; D004338:Drug Combinations; D004987:Ethers / Q000627:therapeutic use; D006801:Humans; D066298:In Vitro Techniques; D008096:Lithotripsy; D008738:Methyl Ethers; D011422:Propionates / Q000627:therapeutic use; D012997:Solvents / Q000627:therapeutic use*
chemical_list: D000085:Acetates; D004338:Drug Combinations; D004987:Ethers; D008738:Methyl Ethers; D011422:Propionates; D012997:Solvents; C069372:isopropyl acetate; C043243:methyl tert-butyl ether; D002784:Cholesterol; C069373:ethyl propionate; D004121:Dimethyl Sulfoxide