Eidsvoll B E, Aadland E, Stiris M, Lunde O C
Dept. of Medicine, Aker University Hospital, Oslo, Norway.
Scand J Gastroenterol. 1993 Aug;28(8):744-8. doi: 10.3109/00365529309098284.
The safety and efficacy of methyl tert-butyl ether (MTBE) dissolution of cholesterol gallbladder stones were evaluated in 25 patients with increased risk for surgery. Two patients were treated twice. The MTBE was infused and aspirated manually through a percutaneous transhepatic catheter to the gallbladder. The placement of the catheter failed in three patients (11%). In 19 of 24 patients (79%) there was complete dissolution of stones after a mean treatment time of 12.2 h (range, 4.3-19.5 h). In five patients treatment was discontinued before complete dissolution owing to technical problems or side effects. Side effects were nausea, pain, vasovagal reaction, and fever. Fifteen patients were followed up for a mean of 15.7 months after dissolution. Stone recurrence was found in eight patients, five of whom suffered symptomatic relapse. We conclude that dissolution therapy with MTBE is a safe and adequate alternative to surgery in selected high-risk patients.
对25例手术风险增加的患者评估了甲基叔丁基醚（MTBE）溶解胆固醇性胆囊结石的安全性和有效性。2例患者接受了两次治疗。通过经皮肝穿刺导管手动将MTBE注入并抽吸至胆囊。3例患者（11%）导管放置失败。24例患者中有19例（79%）在平均治疗时间12.2小时（范围4.3 - 19.5小时）后结石完全溶解。5例患者因技术问题或副作用在结石完全溶解前停止治疗。副作用包括恶心、疼痛、血管迷走反应和发热。15例患者在溶解后平均随访15.7个月。8例患者发现结石复发，其中5例出现症状复发。我们得出结论，对于选定的高风险患者，MTBE溶解疗法是一种安全且合适的手术替代方法。
