M C Soulen1, K L Sullivan. 1. Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia 19104, USA.
Abstract
PURPOSE: Transcatheter ablation of the gallbladder has been attempted in animals and humans with a variety of chemical and physical agents. Initial in vitro experiments suggested sodium hydroxide and hydrogen peroxide were more effective sclerosants than previously reported chemical agents. A phase I trial of escalating concentrations of and exposure times to these agents was performed in vivo. MATERIALS AND METHODS: Fourteen domestic pigs underwent cholecystostomy tube placement and cystic duct ligation. Two weeks later, sclerosis was performed with sodium hydroxide/ethanol solutions and hydrogen peroxide. RESULTS: Sequential 15- or 30-minute exposures to 0.1 N solutions of sodium hydroxide in ethanol followed by 3% peroxide failed to completely eliminate the pig gallbladder epithelium in vivo; 0.5 N and 1.0 N sodium hydroxide in ethanol caused gross gallbladder hemorrhage, mural dissection, and one perforation. Although the gallbladder lumen was ablated, the gallbladder epithelium was not completely eliminated in any animal. CONCLUSION: Chemical ablation of the pig gallbladder epithelium was not feasible in this experimental model.
PURPOSE: Transcatheter ablation of the gallbladder has been attempted in animals and humans with a variety of chemical and physical agents. Initial in vitro experiments suggested sodium hydroxide and hydrogen peroxide were more effective sclerosants than previously reported chemical agents. A phase I trial of escalating concentrations of and exposure times to these agents was performed in vivo. MATERIALS AND METHODS: Fourteen domestic pigs underwent cholecystostomy tube placement and cystic duct ligation. Two weeks later, sclerosis was performed with sodium hydroxide/ethanol solutions and hydrogen peroxide. RESULTS: Sequential 15- or 30-minute exposures to 0.1 N solutions of sodium hydroxide in ethanol followed by 3% peroxide failed to completely eliminate the pig gallbladder epithelium in vivo; 0.5 N and 1.0 N sodium hydroxide in ethanol caused gross gallbladder hemorrhage, mural dissection, and one perforation. Although the gallbladder lumen was ablated, the gallbladder epithelium was not completely eliminated in any animal. CONCLUSION: Chemical ablation of the pig gallbladder epithelium was not feasible in this experimental model.