title: Combined ultrasound-guided extracorporeal shockwave lithotripsy and MTBE instillation in the treatment of common bile duct stones.
abstract: We report on our initial experience in the treatment of 4 patients with common bile duct stones with extracorporeal shockwave lithotripsy, either alone or in combination with methyl-tert-butyl ether. In four patients, common bile duct stones were successfully fragmented employing a second-generation ultrasound-guided piezoelectric lithotripter (EDAP LT-01). In two of these patients direct application of methyl-tert-butyl ether to the gallstone was utilized to assist in dissolution. There was no mortality or morbidity attributable to either treatment modality. In this first report of this combination of treatments we conclude that ESWL probably has a complementary role to play in the management of patients with common bile duct stones.
authors.affiliation: Department of Clinical Surgery and Gastroenterology, The Meath Hospital, Trinity College, Dublin.
authors.forename: A
authors.initials: A
authors.lastname: Darzi
authors.forename: J R
authors.initials: JR
authors.lastname: Monson
authors.forename: P W
authors.initials: PW
authors.lastname: Keeling
authors.forename: C
authors.initials: C
authors.lastname: O'Morain
authors.forename: W A
authors.initials: WA
authors.lastname: Tanner
authors.forename: F B
authors.initials: FB
authors.lastname: Keane
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003131:Combined Modality Therapy; D004987:Ethers / Q000627:therapeutic use*; D005260:Female; D042882:Gallstones / Q000628:therapy*; D006801:Humans; D007322:Instillation, Drug; D008096:Lithotripsy; D008297:Male; D008738:Methyl Ethers; D008875:Middle Aged; D012997:Solvents / Q000627:therapeutic use
chemical_list: D004987:Ethers; D008738:Methyl Ethers; D012997:Solvents; C043243:methyl tert-butyl ether