Agents for gallstone dissolution

Pitt, Henry A.; McFadden, David W.; Gadacz, Thomas R.

doi:10.1016/0002-9610(87)90822-1

Cited by 34 publications

(4 citation statements)

References 91 publications

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“…Long-term administration of bile salts and chenodeoxycholic and orsodeoxycholic acids have been used to dissolve cholesterol gallstones. What the long-term effects of that technique might be on a child is unknown, but the stimulation of colonic epithelial cell proliferation in terms of induction of malignancy, as well as the association of this treatment with frequent bowel movements and diarrhea, is of some concern [10].…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic cholecystectomy: Treatment of choice for cholelithiasis in children

et al. 1993

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Laparoscopic cholecystectomy is rapidly replacing traditional cholecystectomy as the standard treatment for cholelithiasis and cholecystitis in adults. Over a period of 16 months, 14 children with a clinical diagnosis of cholelithiasis, ranging in age from 4 to 15 years (mean 12.2), were treated. All had symptoms of abdominal pain or vomiting; one had jaundice and recurrent cholecystitis. Five children (35%) had associated metabolic or hemolytic diseases. The 14 children were operated on using the laparoscopic cholecystectomy technique. No operation was converted to open cholecystectomy, but two patients required laparotomy: one because of suspected injury to the common duct, and the other because of nonvisualization of the gallbladder during laparoscopy. The mean post-operative hospital stay for the 11 children who underwent only laparoscopic cholecystectomy (one patient also had a simple mastectomy) was 50 hours (range 48-72 hours). All children resumed their normal activities almost immediately after discharge from hospital. No long-term biliary or other complications were seen in any patient throughout an average follow-up period of 6.2 months (range 3-16 months). The benefits of this operation in children are obvious: It is safe, effective, and well tolerated.

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Section: Discussionmentioning

confidence: 99%

Laparoscopic cholecystectomy: Treatment of choice for cholelithiasis in children

et al. 1993

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“…Until now, numerous investigators have developed, or applied, a variety of compounds in dissolving gallstones. The compounds include MTBE, heparin, bile acid, d-limonene, mono-octanoin, EDTA, and sodium hexametaphosphate, all of which are composed of aliphatic chains [15]. Of these, MTBE is the only compound currently available.…”

Section: Discussionmentioning

confidence: 99%

“…In this study, we first developed a gallstone-dissolving compound with an aromatic moiety, named 2-methoxy-6-methylpyridine (MMP). To date, various compounds have been used to dissolve gallstones, including MTBE, heparin, bile acid, d -limonene, mono-octanoin, ethylenediamine tetraacetic acid (EDTA), and sodium hexametaphosphate, all of which are composed of aliphatic chains [15, 16]. MTBE has an asymmetric chemical structure that contains an ether functional group.…”

Section: Introductionmentioning

confidence: 99%

Efficacy and safety of a novel topical agent for gallstone dissolution: 2-methoxy-6-methylpyridine

et al. 2019

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Background Although methyl-tertiary butyl ether (MTBE) is the only clinical topical agent for gallstone dissolution, its use is limited by its side effects mostly arising from a relatively low boiling point (55 °C). In this study, we developed the gallstone-dissolving compound containing an aromatic moiety, named 2-methoxy-6-methylpyridine (MMP) with higher boiling point (156 °C), and compared its effectiveness and toxicities with MTBE. Methods The dissolubility of MTBE and MMP in vitro was determined by placing human gallstones in glass containers with either solvent and, then, measuring their dry weights. Their dissolubility in vivo was determined by comparing the weights of solvent-treated gallstones and control (dimethyl sulfoxide)-treated gallstones, after directly injecting each solvent into the gallbladder in hamster models with cholesterol and pigmented gallstones. Results In the in vitro dissolution test, MMP demonstrated statistically higher dissolubility than did MTBE for cholesterol and pigmented gallstones (88.2% vs. 65.7%, 50.8% vs. 29.0%, respectively; P < 0.05). In the in vivo experiments, MMP exhibited 59.0% and 54.3% dissolubility for cholesterol and pigmented gallstones, respectively, which were significantly higher than those of MTBE (50.0% and 32.0%, respectively; P < 0.05). The immunohistochemical stains of gallbladder specimens obtained from the MMP-treated hamsters demonstrated that MMP did not significantly increase the expression of cleaved caspase 9 or significantly decrease the expression of proliferation cell nuclear antigen. Conclusions This study demonstrated that MMP has better potential than does MTBE in dissolving gallstones, especially pigmented gallstones, while resulting in lesser toxicities. Electronic supplementary material The online version of this article (10.1186/s12967-019-1943-y) contains supplementary material, which is available to authorized users.

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“…On the other hand, MTBE, a structural analogue of diethyl ether, remains a liquid until 55.2°C 7 allowing much more tolerable and effective in vivo use. Additional clinical advantages are MTBE's ability to dissolve the cholesterol in biliary stones as much as 50 times faster than the current solvent of choice, monooctanoin, 2,8,9 and its lower explosive potential relative to that of diethyl ether. These properties were met with enthusiasm by many investigators, and studies reporting successful gallstone dissolution appeared with increasing frequency in the United States.…”

mentioning

confidence: 99%

New Approaches to Common Bile Duct Calculi - Roles of MethylTert-Butyl Ether, Monooctanoin, and Mechanical Fragmentation

Brandon¹,

Teplick²

1988

Semin intervent Radiol

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Agents for gallstone dissolution

Cited by 34 publications

References 91 publications

Laparoscopic cholecystectomy: Treatment of choice for cholelithiasis in children

Laparoscopic cholecystectomy: Treatment of choice for cholelithiasis in children

Efficacy and safety of a novel topical agent for gallstone dissolution: 2-methoxy-6-methylpyridine

New Approaches to Common Bile Duct Calculi - Roles of MethylTert-Butyl Ether, Monooctanoin, and Mechanical Fragmentation

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