Cholelitholysis Using Methyl Tertiary Butyl Ether

Allen, Mark; Borody, Thomas J.; Bugliosi, Thomas F.; May, Gerald R.; LaRusso, Nicholas F.; Thistle, Johnson L.

doi:10.1016/s0016-5085(85)80143-8

Cited by 130 publications

(26 citation statements)

References 10 publications

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“…Gastroscopy and endoscopic bile aspiration were carried out one to seven days (mean (SD) [2][3][4] ( 1 7) Tables II and III). There was no significant correlation between the total lipid concentrations of the bile obtained endoscopically and those obtained through fine needle puncture (r=0 55; NS).…”

Section: Introductionmentioning

confidence: 99%

Comparison of gall bladder bile and endoscopically obtained duodenal bile.

Janowitz¹,

Swobodnik²,

Wechsler³

et al. 1990

Gut

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In 10 patients with gail stone disease (eight women, two men; mean (SD) age 47-4 (13) years), bile was obtained by endoscopic aspiration after stimulation of the gail bladder with ceruletid and also by fine needle puncture of the gall bladder under local anaesthetic. The total lipid concentration of the puncture bile samples was mean (SD) 11*9 (4.7) g/dl, significantly higher than the endoscopic bile samples (3.9 (3.3) g/dl, p<0 001). Total bile acids, phospholipids, and biliary cholesterol (expressed in mol%) and cholesterol saturation index showed no significant differences between the two types of samples. The glycocholic acid concentration in the endoscopicaily obtained bile (27.7 (6.6) mol% v 23-3 (5.4) mol%; p<0 01) was significantly higher than the puncture bile samples. Puncture bile exhibited a significantly shorter nucleation time (3.5 (3.3) days v 19*6 (11.9) days; p

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Section: Introductionmentioning

confidence: 99%

Comparison of gall bladder bile and endoscopically obtained duodenal bile.

Janowitz¹,

Swobodnik²,

Wechsler³

et al. 1990

Gut

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“…In patients in whom MTBE has been used for contact dissolution of cholesterol gallstones there have been no reports of serious systemic toxic effects. Nonetheless, MTBE has central nervous system side effects such as somnolence, nausea, and vomiting; abdominal pain suggesting local tissue irritation has also been described (7,12,16,18,19,(24)(25)(26)(27) In this study, we examined blood levels of EP and MTBE during gallbladder instillation in the piglet under conditions simulating contact dissolution of cholesterol gallbladder stones in human beings. We tested the hypothesis that blood levels of EP would be lower than those of MTBE because of the more rapid metabolism of EP.…”

Section: W F Hofmann~mentioning

confidence: 99%

Increased blood levels of methyl tert-butyl ether but not of ethyl propionate during instillation with contact gallstone dissolution agents in the pig

et al. 1993

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We performed experiments in anesthetized piglets with two cholesterol gallstone solvents, methyl tert-butyl ether and ethyl propionate, to determine whether blood levels of either solvent would increase during gallbladder instillation of these solvents under conditions simulating gallstone dissolution. The solvent was oscillated rapidly in and out of the gallbladder with a computer-controlled syringe pump; intraluminal pressure was set below the leakage pressure, and oscillating volume was set below the leakage volume to decrease loss of solvent into the intestine. Blood levels were measured with gas chromatography. Six piglets received methyl tert-butyl ether, and six piglets received ethyl propionate. During 2 hr of instillation with methyl tert-butyl ether, blood levels increased steadily to concentrations averaging 0.3 ml/L blood at 2 hr; during a 6-hr period of instillation, blood levels rose to above 0.4 ml/L blood. Replacement of methyl tert-butyl ether with saline solution in the gallbladder caused blood levels to decline gradually; plasma levels decreased by half in 90 min. In contrast, when ethyl propionate was infused for 2 or 6 hr, blood levels remained below the detection limit, probably because of high first-pass hepatic extraction. We conclude that, under conditions simulating those likely present in patients undergoing contact dissolution of gallbladder stones, the two solvents differ: Ethyl propionate is removed so rapidly from blood that its levels remain undetectable, whereas methyl tert-butyl ether levels in blood (and, presumably, peripheral tissues) increase continuously.(ABSTRACT TRUNCATED AT 250 WORDS)

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“…The animals were randomly allocated to two groups: four rabbits were given intraductal MTBE (Fluka AG, Buchs, Switzerland; 1 ml/kg body wt daily for two days), the others received equal amounts of intraductal saline. Both solutions were infused continuously through the indwelling biliary drainage at a rate of 1 …”

Section: Animal Experimentsmentioning

confidence: 99%

Unexpected dilatation of the common bile duct after methyl tertiary butyl ether (MTBE) in rabbits. Possible implications to findings in man.

Tritapepe

Pozzi

Caspani

et al. 1989

Gut

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SUMMARY Methyl tertiary butyl ether (MTBE) rapidly dissolves cholesterol gall stones in vitro and in vivo. To further characterise tolerability and safety of this aliphatic ether, either MTBE (1 ml/kg body wt daily for two days) or an equal amount of saline was infused into the common bile duct (CBD) ofeight cholecystectomised rabbits. Transient vomiting, dyspnoea and somnolence developed during MTBE instillation. Post-treatment values of serum transaminases and alkaline phosphatase were significantly higher in MTBE than in saline treated animals. Cholangiography one week after the last intraductal infusion showed a five-fold increase of CBD size in MTBE v control rabbits. At autopsy histological signs of chemical cholangitis and mild duodenitis were noted in MTBE treated animals. Prompted by these findings, we performed a cholangiography in two patients who had received intraductal MTBE (about 0-2 ml/kg body wt daily for one or two days) one year before: an abnormal dilatation of the CBD was present, which might represent a specific, hitherto undescribed permanent sequela of MTBE administration. Methvl tertiary butyl ether (MTBE) is

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Cholelitholysis Using Methyl Tertiary Butyl Ether

Cited by 130 publications

References 10 publications

Comparison of gall bladder bile and endoscopically obtained duodenal bile.

Comparison of gall bladder bile and endoscopically obtained duodenal bile.

Increased blood levels of methyl tert-butyl ether but not of ethyl propionate during instillation with contact gallstone dissolution agents in the pig

Unexpected dilatation of the common bile duct after methyl tertiary butyl ether (MTBE) in rabbits. Possible implications to findings in man.

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