RT Journal Article SR Electronic T1 Choledocholithiasis--in vivo stone dissolution using methyl tertiary butyl ether (MTBE). JF Gut JO Gut FD BMJ Publishing Group Ltd and British Society of Gastroenterology SP 143 OP 145 DO 10.1136/gut.29.2.143 VO 29 IS 2 A1 Murray, W R A1 LaFerla, G A1 Fullarton, G M YR 1988 UL http://gut.bmj.com/content/29/2/143.abstract AB We report a series of 10 elderly patients with large bile duct calculi refractory to standard endoscopic extraction techniques who were treated by gall stone dissolution using methyl tertiary butyl ether (MTBE) instilled through a nasobiliary catheter. In eight patients complete bile duct clearance was achieved after an average of eight hours MTBE instillation. In two patients gall stone size did not change. Both underwent operative gall stone removal and subsequent stone analysis showed low cholesterol content, which is unlikely to respond to MTBE. Apart from occasional transient nausea and drowsiness, no adverse reactions were noted. Methyl tertiary butyl ether appears to be a powerful in vivo gall stone dissolution agent which, from preliminary studies, is not associated with serious toxicity.