Gallstone dissolution with methyl-tert-butyl ether via percutaneous cholecystostomy: success and caveats

Allen et al. [1] recently reported the first successful case of contact dissolution of multiple small gallbladder stones by methyl-tertiary-butyl ether (MTBE), an aliphatic ether that is not volatile at body temperature and dissolves cholesterol gallstones rapidly in vitro [2]. We report our initial experience with MTBE, which although successful, differed in many respects from the prior case. The gallstone in our patient was large and solitary and obstructed the cystic duct. In addition, side effects occurred with MTBE, and previous monooctanoin infusion was unsuccessful. We wish to document the benefits of MTBE and alert radiologists and clinicians to the adverse effects that occurred.