Dissolution of bile duct stones.

Mono-octanoin can be used either alone or as an adjunct to other techniques to dissolve cholesterol bile duct stones. This solvent can be administered through an existing T tube, through the nasobiliary route, or percutaneously through the liver. Unlike basket extraction, which requires a mature T-tube sinus tract, mono-octanoin can be used immediately postoperatively or for home dissolution therapy. The endoscopic extraction of bile duct stones has a 1 percent mortality rate and a 5 to 7 percent complication rate. Special mixtures of mono-octanoin, bile acids, and ethylene diaminetetraacetic acid (EDTA) are being evaluated to dissolve pigment stones. The use of methyl tert-butyl ether is still experimental but very effective. To be most successful, mono-octanoin treatment must be used in properly selected patients.