Laparoscopic cholecystectomy using methyl tert-butyl ether: preliminary results

We evaluated the usefulness of methyl tert-butyl ether in gallbladder extraction during laparoscopic cholecystectomy when large stones are present. Five patients with symptomatic gallbladder stones larger than 30 mm underwent laparoscopic cholecystectomy according to the standard procedure. Extraction of the gallbladder without enlarging the 10-mm orifice was not possible because of the large stones. We infused MTBE in the gallbladder through a 9-French polyethylene catheter passed into its neck already pulled out of the umbilical port. The solvent was injected, aspirated after 10 to 15 s, and then immediately reinjected. This procedure continued until the stones softened and it became possible to crush and to remove them easily with a forceps or aspirator. The mean duration of the entire procedure was 7.7 +/- 1.57 min. Methyl tert-butyl ether infusion should be considered during laparoscopic cholecystectomy because it is a cheap and fast method to allow gallbladder extraction when large stones are present.