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Digestive Diseases and Sciences

, Volume 40, Issue 8, pp 1775–1781 | Cite as

Gallstone recurrence after direct contact dissolution with methyltert-butyl ether

  • Juergen Pauletzki
  • Joseph Holl
  • Michael Sackmann
  • Michael Neubrand
  • Ulrich Klueppelberg
  • Tilman Sauerbruch
  • Gustav Paumgartner
Pancreatic and Biliary Disorders

Abstract

To determine the rate and characteristics of gallstone recurrence after direct contact dissolution with methyltert-butyl ether, 60 consecutive patients were followed for up to 4.5 years (median 2.2 years) after complete disappearance of all stone residues and debris and cessation of adjuvant bile acid therapy. Initial gallstones had been multiple in all but four patients. Twenty-eight of the 60 patients developed recurrent gallstones. The cumulative risk of gallstone recurrence (actuarial analysis) was 23±6%, 34±7%, 55±8%, and 70±9% at one, two, three, and four years, respectively. The recurrent stones were usually multiple and small (6±4 mm). Gallstone recurrence was associated with recurrent biliary pain in two patients, one of whom developed acute cholecystitis. Recurrent stones were cleared completely by bile acid medication with or without shock-wave lithotripsy in 61±15% of patients at one year (actuarial analysis). In conclusion, gallstone recurrence after successful contact dissolution of multiple stones with methyltert-butyl ether has to be expected in a high percentage of patients. Most patients, however, remain free of biliary pain during long-term follow-up.

Key Words

methyltert-butyl ether cholelithiasis gallstone dissolution gallstone recurrence 

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Copyright information

© Plenum Publishing Corporation 1995

Authors and Affiliations

  • Juergen Pauletzki
    • 1
  • Joseph Holl
    • 1
  • Michael Sackmann
    • 1
  • Michael Neubrand
    • 1
  • Ulrich Klueppelberg
    • 1
  • Tilman Sauerbruch
    • 1
  • Gustav Paumgartner
    • 1
  1. 1.Department of Medicine II, Klinikum GrosshadernUniversity of MunichMunichGermany

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