Extracorporeal shock-wave lithotripsy and methyl tert-butyl ether for partially calcified gallstones

Craig J. Peine, Bret Thomas Petersen, Hugh J. Williams, Claire E. Bender, David E. Patterson, Joseph W. Segura, David M. Nagorney, Mark A. Warner, Johnson L. Thistle

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

To explore the possibility that gallbladder stone fragments might be able to be safely dissolved using methyl tert-butyl ether immediately after extracorporeal shock-wave lithotripsy (ESWL), a feasibility study in 8 patients with one to four partially calcified gallbladder stones was performed. The gallstones averaged 2.2 cm in diameter (range 1.3-3 cm) and contained layered or diffuse calcium detectable by computed tomography scan only (7 patients) or plain film (1 patient). After a 5F (1.7 mm) pigtail catheter was placed percutaneously into the gallbladder, ESWL fragmentation was performed using a renal stone lithotriptor. The patients were under general anesthesia and in the prone position on a support gantry designed for gallbladder stone ESWL. Following ESWL, methyl tert-butyl ether was infused and aspirated via the gallbladder catheter until no further stone material was radiologically detectable or could be dissolved. After 8-26 h (mean = 13 h) of methyl tert-butyl ether therapy, no radiologically detectable gallstones remained in 6 of 8 patients. Shell fragments of three peripherally calcified stones in 1 patient and the densely calcified, predominantly pigment stone in a second patient were refractory to combined therapy. Both ESWL and treatment with methyl tert-butyl ether were well tolerated in all patients, although bile leakage after catheter removal occurred in 3 patients, one of whom was treated by cholecystectomy. Additional measures to prevent bile leakage may be advisable if these two modalities are to be used in tandem. We found no evidence, however, that predissolution stone fragmentation with ESWL predisposed the gallbladder to either mucosal damage by methyl tert-butyl ether or increased absorption of it.

Original languageEnglish (US)
Pages (from-to)1229-1235
Number of pages7
JournalGastroenterology
Volume97
Issue number5
StatePublished - 1989

Fingerprint

Lithotripsy
Gallstones
Shock
Gallbladder
Catheters
Bile
methyl tert-butyl ether
Prone Position
Feasibility Studies
Cholecystectomy
Motion Pictures
General Anesthesia
Therapeutics
Tomography
Calcium
Kidney

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Peine, C. J., Petersen, B. T., Williams, H. J., Bender, C. E., Patterson, D. E., Segura, J. W., ... Thistle, J. L. (1989). Extracorporeal shock-wave lithotripsy and methyl tert-butyl ether for partially calcified gallstones. Gastroenterology, 97(5), 1229-1235.

Extracorporeal shock-wave lithotripsy and methyl tert-butyl ether for partially calcified gallstones. / Peine, Craig J.; Petersen, Bret Thomas; Williams, Hugh J.; Bender, Claire E.; Patterson, David E.; Segura, Joseph W.; Nagorney, David M.; Warner, Mark A.; Thistle, Johnson L.

In: Gastroenterology, Vol. 97, No. 5, 1989, p. 1229-1235.

Research output: Contribution to journalArticle

Peine, CJ, Petersen, BT, Williams, HJ, Bender, CE, Patterson, DE, Segura, JW, Nagorney, DM, Warner, MA & Thistle, JL 1989, 'Extracorporeal shock-wave lithotripsy and methyl tert-butyl ether for partially calcified gallstones', Gastroenterology, vol. 97, no. 5, pp. 1229-1235.
Peine CJ, Petersen BT, Williams HJ, Bender CE, Patterson DE, Segura JW et al. Extracorporeal shock-wave lithotripsy and methyl tert-butyl ether for partially calcified gallstones. Gastroenterology. 1989;97(5):1229-1235.
Peine, Craig J. ; Petersen, Bret Thomas ; Williams, Hugh J. ; Bender, Claire E. ; Patterson, David E. ; Segura, Joseph W. ; Nagorney, David M. ; Warner, Mark A. ; Thistle, Johnson L. / Extracorporeal shock-wave lithotripsy and methyl tert-butyl ether for partially calcified gallstones. In: Gastroenterology. 1989 ; Vol. 97, No. 5. pp. 1229-1235.
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