Jover Clos Rafael J, Álamo Juan P, Matsuzaki Mónica, Dionisio de Caballier Maria E, Bustos Héctor F, Gramatica Luis
Unidad Hospitalaria de Cirugía No 1, Hospital Nacional de Clínicas, Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, Córdoba, Argentina.
Rev Fac Cien Med Univ Nac Cordoba. 2011;68(3):101-6.
The cholecystectomy is the current treatment of the biliary lithiasis. Nevertheless there have been attempts in order to eliminate the gallbladder epithelium and to generate the sclerosis of the organ using chemical substances, heat and laser.
Sodium hypochlorite and fibrin glue is proposed to achieve the ablation of the gallbladder mucosa and sclerosis.
Thirty rabbits were divided into three groups of 10. Accessing surgically to the gallbladder, sodium hypochlorite was injected, afterward the same was done with fibrin glue to occlude the cystic duct and collapse the organ lumen, avoiding the bile reflux. In the control groups ethanol plus fibrin adhesive and physiological solution was used. In day 65 the animals were sacrificed and the result of the procedure was observed macroscopic and histologically.
Eight of the gallbladders treated with sodium hypochlorite disappeared leaving a small subhepatic scar. There were no intra nor postoperative complications. In the group of the ethanol the result was successful only in one case, and with saline solution there was no ablation. A significant difference exists for the group treated with sodium hypochlorite plus fibrin glue compared to the ethanol plus fibrin adhesive group (p <0,0055) and the saline solution group (p <0,0007).
In this experimental model there was possible the ablation of the gallbladder using sodium hypochlorite as sclerosing agent and fibrin glue to collapse the lumen and to occlude the cystic duct.
胆囊切除术是目前治疗胆石症的方法。然而，人们一直在尝试使用化学物质、热和激光来消除胆囊上皮并使器官硬化。
提出使用次氯酸钠和纤维蛋白胶来实现胆囊黏膜消融和硬化。
将30只兔子分为三组，每组10只。通过手术进入胆囊，注射次氯酸钠，然后用纤维蛋白胶进行同样操作以阻塞胆囊管并使器官腔塌陷，避免胆汁反流。在对照组中使用乙醇加纤维蛋白粘合剂和生理盐水。在第65天处死动物，从宏观和组织学上观察手术结果。
用次氯酸钠治疗的8个胆囊消失，留下一个小的肝下瘢痕。术中及术后均无并发症。在乙醇组中，仅1例结果成功，而用生理盐水则无消融效果。与乙醇加纤维蛋白粘合剂组（p <0.0055）和生理盐水组（p <0.0007）相比，次氯酸钠加纤维蛋白胶治疗组存在显著差异。
在该实验模型中，使用次氯酸钠作为硬化剂并结合纤维蛋白胶使管腔塌陷和阻塞胆囊管，有可能实现胆囊消融。
