Aydin Cemalettin, Kayaalp Cuneyt, Nessar Gurel, Zengin Neslihan, Balkan Mujdat, Unal Bulent, Ozgurtas Taner
Inonu University, Turgut Ozal Medical Center, Department of General Surgery, Malatya, Turkey.
Turkey Yuksek Ihtisas Hospital, Department of Gastrointestinal Surgery, Ankara, Turke.
Adv Clin Exp Med. 2014 May-Jun;23(3):395-8. doi: 10.17219/acem/37131.
The liver is the most frequent organ for placement of hydatid cyst disease. All known protoscolicidals that are used for echinococcus degeneration have a risk of caustic secondary sclerosing cholangitis. The cetrimide-chlorhexidine combination is an effective protoscolicidal agent for treatment of hydatid liver cysts.
The aim of this experimental study was to examine this combination for potential risks of caustic secondary sclerosing cholangitis.
Thirty rats were enrolled and divided into two groups. In the study group, 0.15 mL of a cetrimide (0.5%) and chlorhexidine (0.05%) combination was injected into the bile ducts for five minutes. The control group included the same amount of normal saline and waiting period. The rats were followed for 120 days and the living rats were examined for biliary injury by biochemical analysis and histopathology.
No specific histopathological findings for caustic sclerosing cholangitis such as bile duct stricture or periductal fibrosis were present in any groups. Other pathological criteria demonstrating inflammation including portal inflammation, bile duct proliferation and necrosis were similar in both groups. Biochemical analysis including a liver function test (aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase, gamma-glutamyltranspeptidase) appeared similar to the control group.
A cetrimide 0.5% and chlorhexidine 0.05% combination has similar liver function results and histopathological effects to normal saline on bile ducts and it appears to be safe for bile ducts.
肝脏是包虫囊肿病最常累及的器官。所有已知用于棘球蚴退变的原头蚴杀灭剂都有引发腐蚀性继发性硬化性胆管炎的风险。氯己定-洗必泰组合是治疗肝包虫囊肿的一种有效的原头蚴杀灭剂。
本实验研究旨在检测该组合是否存在引发腐蚀性继发性硬化性胆管炎的潜在风险。
纳入30只大鼠并分为两组。在研究组中，将0.15 mL氯己定（0.5%）和洗必泰（0.05%）的组合注入胆管5分钟。对照组注入等量生理盐水并设定相同的等待期。对大鼠进行120天的随访，对存活的大鼠通过生化分析和组织病理学检查胆管损伤情况。
两组均未出现腐蚀性硬化性胆管炎的特异性组织病理学表现，如胆管狭窄或胆管周围纤维化。两组中显示炎症的其他病理标准，包括门管区炎症、胆管增生和坏死，情况相似。包括肝功能检查（天冬氨酸转氨酶、丙氨酸转氨酶、碱性磷酸酶、γ-谷氨酰转肽酶）在内的生化分析结果与对照组相似。
0.5%氯己定和0.05%洗必泰的组合对胆管的肝功能结果和组织病理学影响与生理盐水相似，似乎对胆管是安全的。
