Monooctanoin perfusion for in vivo dissolution of biliary stones. A series of 11 patients.
Monooctanoin, a cholesterol solvent, was infused into the biliary system of 11 patients. Twenty-eight (74%) of 38 total stones responded to monooctanoin: 16 (42%) decreased in size, and 12 (32%) dissolved completely. Ten stones (26%) did not change in size. We attribute this to inadequate drug-stone contact, which was corrected by placement of the infusion catheter contiguous to the stone(s). The use of a second catheter for biliary drainage avoided the side effect of biliary colic and increased patient compliance. An infusion rate greater than 5 ml per hour invariably produced pain and diarrhea. There were no significant side effects from monooctanoin in any of our patients when a two catheter system and an infusion rate of 5 ml per hour or less were used. A major drawback to use of this still experimental agent is the prolonged hospital stay. This may be ameliorated when at home use of monooctanoin is approved.
D000328:Adult; D000368:Aged; D001649:Bile Duct Diseases / Q000188:drug therapy; D002210:Caprylates; D002769:Cholelithiasis / Q000188:drug therapy*; D005989:Glycerides / Q000008:administration & dosage* / Q000009:adverse effects; D006801:Humans; D008875:Middle Aged; D010477:Perfusion
D002210:Caprylates; D005989:Glycerides; C025343:monooctanoin