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Instillation of Methyl tert-butyl ether in the gallbladder permits the dissolution of cholesterol stones. Percutaneous transhepatic puncture of the gallbladder is the currently used approach; but shortcomings of this procedure could make the transpapillary cannulation of the cystic duct preferable. The reproducibility of this procedure, however, is not established. "In situ" dissolution is useful in cases of multiples stones which are not amenable to treatment with extra corporeal shock wave lithotripsy (ESWL). It can also be complementary to standard ESWL by promoting rapid disappearance of stones fragments. Preliminary results obtained in 9 patients suggest the necessity of rigorous selection criterias particularly regarding the chemical nature of the stones.
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