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Percutaneous contact dissolution of gallstones: complexity of radiologic care.
Mueller PR, Lee MJ, Saini S, Brink JA, Hahn PF, Dawson SL, Kammer B, Morrison MC, Shortsleeve M, Ferrucci JT.
Department of Radiology, Massachusetts General Hospital, Boston 02114.
Radiographics. 1991 Sep;11(5):759-70.
The clinical and technical considerations for successful gallstone dissolution with methyl tert-butyl ether (MTBE) are often underestimated. Patients are selected for MTBE therapy on the basis of a functioning gallbladder without evidence of acute inflammation or calcified stones at plain radiography. A transhepatic route is favored for percutaneous insertion of the cholecystostomy catheter because of the theoretic reduced frequency of bile leakage. MTBE is delivered manually through the catheter in a closed system, with dissolution times of 4-16 hours. After MTBE dissolution, residual debris in the gallbladder is present at follow-up sonography in up to 75% of patients. The high frequency of residual debris, the potential for stone recurrence, and the labor-intensive nature of MTBE therapy make its future uncertain, especially with the advent of laparoscopic cholecystectomy.
Posted via PubMed for educational and discussion purposes only.
Link to PubMed Reference
Department of Radiology, Massachusetts General Hospital, Boston 02114.
Radiographics. 1991 Sep;11(5):759-70.
The clinical and technical considerations for successful gallstone dissolution with methyl tert-butyl ether (MTBE) are often underestimated. Patients are selected for MTBE therapy on the basis of a functioning gallbladder without evidence of acute inflammation or calcified stones at plain radiography. A transhepatic route is favored for percutaneous insertion of the cholecystostomy catheter because of the theoretic reduced frequency of bile leakage. MTBE is delivered manually through the catheter in a closed system, with dissolution times of 4-16 hours. After MTBE dissolution, residual debris in the gallbladder is present at follow-up sonography in up to 75% of patients. The high frequency of residual debris, the potential for stone recurrence, and the labor-intensive nature of MTBE therapy make its future uncertain, especially with the advent of laparoscopic cholecystectomy.
Posted via PubMed for educational and discussion purposes only.
Link to PubMed Reference
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