Premium
Treatment of cholelithiasis with acetylcysteine, a new gallstone solvent
Author(s) -
Moriyasu Akihito,
Ise Hideo,
Suzuki Noriyoshi,
Matsuno Seiki
Publication year - 1994
Publication title -
journal of hepato‐biliary‐pancreatic surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.63
H-Index - 60
eISSN - 1868-6982
pISSN - 0944-1166
DOI - 10.1007/bf02391104
Subject(s) - gallstones , acetylcysteine , lithotripsy , medicine , percutaneous , hepatolithiasis , gastroenterology , surgery , chemistry , biochemistry , antioxidant , hepatectomy , resection
An improved technique for making thin sections of gallstones has enabled us to examine their morphology microscopically. Using this technique in various types of gallstones, we found a network of mucin, which was considered to play an important role in gallstone formation. The effectiveness of a mucolytic agent, acetylcysteine, for the direct dissolution of gallstones was evaluated in this study. Immersion in acetycysteine led to the prompt disintegration of various types of gallstones into small fragments. As acetylcysteine is commercially available as a mucolytic agent, a clinical trial was undertaken for the treatment of cholelithiasis (hepatolithiasis, n = 5; choledocholithiasis, n = 1). Because of the disintegrating effect of acetylcysteine, after the injection of this agent, many fragments flowed out through the percutaneous transhepatic biliary drainage tube. Acetylcysteine gallstone dissolution combined with percutaneous transhepatic cholangioscopic lithotripsy significantly aided the lithotriptic action, due to the disappearance of mucin from the bile duct. No side effects were observed either during or after the treatment. We concluded that acetylcysteine can be used as a new agent for the direct dissolution of most types of gallstones in patients with cholelithiasis.