Injection of a silicone prepolymer system into the gallbladder of rabbits.

The aim of this study was to assess the feasibility of a new nonsurgical treatment for cholelithiasis. This involved injecting a liquid prepolymer into the gallbladder which would polymerize in situ, entrapping existing gallstones and permanently filling the gallbladder so as to prevent subsequent gallstone formation. Initially, several silicone prepolymer mixtures were tested in vitro for viscosity, cure time, radiopacity, and consistency when polymerized. The optimal system with regard to these parameters consisted of two room temperature vulcanizing silicones (3110 and 200), a catalyst (F), and barium sulfate. This mixture was then injected into beakers containing human gallstones alone and in combination with bile, and was periodically evaluated over six months. It was also injected into the gallbladder of six rabbits and left for 12 weeks. No clinical complications were noted in any of the animals. The cured silicone system maintained its original shape and did not fragment. At necropsy, the casts were free in the rabbits' gallbladders, with small accumulations of biliary sludge adhered to their surfaces. No mucocele of the gallbladder was found in any of the rabbits. Cholecystic histology was normal in all cases, and only one animal exhibited a mild chronic portal triaditis. These promising results indicate the need for further studies of the technique and refinement of the silicone formulation.