RESUMEN
Contact dissolution with MTBE is an effective and safe method to treat symptomatic patients with cholesterol gallstones. Personnel, time, and safety factors have limited widespread use of the procedure. With current competing methods to treat gallstones, it is likely that MTBE use will be reserved for those patients who elect percutaneous therapy due to fear of surgery or anesthesia and in those elderly patients who are compromised by underlying medical conditions.
Asunto(s)
Colelitiasis/terapia , Éteres/uso terapéutico , Éteres Metílicos , Éteres/administración & dosificación , Éteres/efectos adversos , HumanosRESUMEN
The authors describe their initial experience with a dedicated intraluminal ultrasound (US) device that was coupled to a catheter and introduced percutaneously into the gallbladder and/or bile ducts. Access was created with interventional radiologic techniques in 22 patients and at laparoscopy in four patients. Thirty-one examinations in 26 patients revealed information on normal anatomy, pathologic processes, and responses to therapy. The pathologic processes seen included bile duct and gallbladder debris, stones, ductal strictures, and tumors. Additional information provided with this technique over other diagnostic studies included differentiation of intraluminal filling defects, examination of areas inaccessible to conventional imaging, and observations about the walls of the ducts and gallbladder. Percutaneous US examination of metallic stents within the bile ducts and of filling defects in the ducts at laparoscopic cholecystectomy was of particular interest and altered subsequent therapy. The procedure is simple, straightforward, and devoid of complications. While refinements and improvements are needed, this diagnostic technique holds promise.