title: Combined treatment of symptomatic gallbladder stones by extracorporeal shock-wave lithotripsy (ESWL) and instillation of methyl tert-butyl ether (MTBE).
abstract: Twenty-four patients with symptomatic gallbladder stones (12 radiolucent and 12 calcified) were treated by a combined approach of extracorporeal shock-wave lithotripsy (ESWL) and subsequent instillation of methyl tert-butyl ether (MTBE). The patients received a mean of 1500 +/- 185 shock-wave discharges. The mean instillation time of MTBE was 13 +/- 4.2 hr. Treatment was tolerated without major adverse effects. Within a time period of three to five days eight of 12 patients with pure radiolucent stones and four of 12 with calcified stones became stone-free. After a median follow-up of five months (range: one week to 26 months), a total of 11 patients (92%) with radiolucent stones and of eight patients (66%) of those with calcified stones were free of stones, fragments, or debris. These clearance rates appear high when compared with reports on monotherapy with ESWL or MTBE, suggesting a positive effect of a combined approach in selected patients. Two patients exhibited recurrent stones after six and seven months, respectively.
authors.affiliation: Medical Department II, Klinikum Grosshadern, University of Munich, Germany.
authors.forename: J
authors.initials: J
authors.lastname: Holl
authors.forename: T
authors.initials: T
authors.lastname: Sauerbruch
authors.forename: M
authors.initials: M
authors.lastname: Sackmann
authors.forename: J
authors.initials: J
authors.lastname: Pauletzki
authors.forename: G
authors.initials: G
authors.lastname: Paumgartner
mesh_terms: D002769:Cholelithiasis / Q000000981:diagnostic imaging / Q000628:therapy*; D003131:Combined Modality Therapy; D004987:Ethers / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008096:Lithotripsy; D008297:Male; D008738:Methyl Ethers; D008875:Middle Aged; D011859:Radiography; D012008:Recurrence; D012997:Solvents / Q000627:therapeutic use; D013997:Time Factors
chemical_list: D004987:Ethers; D008738:Methyl Ethers; D012997:Solvents; C043243:methyl tert-butyl ether