Dissolution of cholesterol gallstones using methyl tert-butyl ether.

Symptomatic cholelithiasis affects a large segment of the population. Several nonoperative therapeutic alternatives for treatment of these gallstones have recently been developed. We present here the technical aspects and results of gallstone dissolution in 75 patients with the use of methyl tert-butyl ether (MTBE) administered via a small percutaneously placed cholecystostomy catheter. Successful stone dissolution was achieved in 69 patients. The average time required for stone dissolution was 12.4 h over an average of 2.4 days, with the success and rate of dissolution being very dependent on technique. Six patients have developed recurrent gallstones. Future efforts will focus on decreasing the labor intensity of the procedure, dealing with the noncholesterol components of gallstones, and preventing gallstone recurrence.