In vitro dissolution of cholesterol gallstones

Allen, Mark; Borody, Thomas J.; Thistle, Johnson L.

doi:10.1016/0016-5085(85)90215-x

Cited by 43 publications

(4 citation statements)

References 21 publications

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“…More recently, Thistle [12,26] has published that monooctanoin dissolves cholesterol gallstones 2.5 times faster than cholate solutions in any 24-hour period and stones decreased in size and/or number in 6 of his 7 patients. The same authors, using in vitro and in vivo studies [27], reported disappearance of stones in 8 of 12 patients and progressive decrease in 2.…”

Section: Discussionmentioning

confidence: 99%

Treatment of retained common bile duct stones: A prospective controlled study comparing monooctanoin and heparin

1983

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A prospective controlled trial comparing the efficacy of heparin and monooctanoin as solvents of retained common bile duct stones through the T‐tube is presented. The results were compared to those obtained by the saline washout technique which was used as a retrospective comparison group. After treatment, 33% and 65% of the patients treated with heparinized saline solution and monooctanoin, respectively, showed absence of stones on cholangiograms (p<0.01). In patients submitted to the washout technique, 20% of 54 patients who completed the treatment showed disappearance of stones. Side effects during infusion were more serious in the monooctanoin group and 1 patient developed sepsis in this group. The results of the present study strongly suggest that monooctanoin may be a reasonable alternative treatment for those patients who show residual common bile duct stones after surgery.

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Section: Discussionmentioning

confidence: 99%

Treatment of retained common bile duct stones: A prospective controlled study comparing monooctanoin and heparin

1983

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“…Even though monooctanoin can be a powerful cholesterol solvent, the clinical success rate is because [6]: (1) the best results are achieved only if pure solvent is in constant contact with the stone, and there is rapid convective mixing around it [21,22];…”

Section: Monooctanoin (Capmul 8210)mentioning

confidence: 99%

“…The distinction between the clinically beneficial contribution of MTBE from the delayed but purely mechanical effects of endoscopic sphincterotomy and nasobiliary catheter insertion inevitably involves some subjective assessment. Because of the low viscosity and low density of MTBE, contact between the stones and MTBE may be poor [26] and constant stirring is required to achieve maximum benefit [22]. Table 1 summarizes the cumulated published results with the use of MTBE for the treatment of CBDS.…”

Section: Methyl Tert-butyl Ethermentioning

confidence: 99%

Medical Management of Common Bile Duct Stones

González-Koch

Nervi

1998

World j. surg.

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Common bile duct stones are a common cause of morbidity and mortality in adults. An increasing number of surgical and medical therapies are available to manage them, with different success rates reported. The various medical treatment strategies were developed during the last decade, but these medical modalities should not be contemplated as a first-line alternative of treatment. A consensus from experts is that there is no primary indication to use solvents on common bile duct stones because they have a relatively high rate of adverse effects and their success is limited compared with lithotripsy. However, there is a subgroup of patients in whom invasive or surgical treatment is risky or may fail. In these patients stone dissolution by solvent may constitute a plausible therapeutic alternative or may help reduce the size of the stones sufficiently to facilitate subsequent endoscopic extraction. Solvents may also be indicated in settings where endoscopic techniques or lithotripsy are not available and the patient has a T-tube in the common bile duct. Even in this condition, however, it is probably quicker and more effective to refer the patient to a center with expertise and technologic support to practice stone removal.

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“…5 However, Takacs et al 3 used MTBE in much lower concentrations and reported only mild toxic side effects.…”

mentioning

confidence: 99%