Becker C D, Quenville N F, Burhenne H J
Department of Radiology, University of British Columbia, Vancouver, Canada.
Radiology. 1989 Apr;171(1):235-40. doi: 10.1148/radiology.171.1.2928530.
Twenty pigs underwent (a) cystic duct occlusion by means of fluoroscopically guided transcatheter endoluminal bipolar radio-frequency (RF) electrocoagulation and (b) gallbladder sclerotherapy with one of two different regimens of ethanol and sodium tetradecyl-sulfate (STS). Serum ethanol levels and hepatic enzyme tests showed no acute toxicity. Postmortem histologic studies showed that the bile ducts beyond the occlusion site remained entirely unaffected in all animals. In three of four animals followed up for 2 weeks, the sclerosants induced necrosis of the gallbladder mucosa, but the adjacent liver, serosa, and blood vessels remained intact. In 13 of 16 animals followed up for 8 weeks, the gallbladder lumen was obliterated by fibrous scar tissue. In the animals treated with 95% ethanol and 3% STS, the gallbladder mucosa was necrotic in all areas after 2 weeks (two of two animals) and eradicated completely after 8 weeks (six of eight animals); the other regimen (70% ethanol plus 1% STS) was somewhat less effective. In this study, the combination of RF-mediated cystic duct occlusion and gallbladder sclerotherapy with ethanol and STS permitted gallbladder ablation in swine without toxic side effects.
20头猪接受了以下操作：(a) 在荧光镜引导下通过经导管腔内双极射频（RF）电凝术闭塞胆囊管，以及(b) 使用乙醇和十四烷基硫酸钠（STS）两种不同方案之一进行胆囊硬化治疗。血清乙醇水平和肝酶检测未显示急性毒性。尸检组织学研究表明，闭塞部位以外的胆管在所有动物中均完全未受影响。在随访2周的4只动物中的3只中，硬化剂导致胆囊黏膜坏死，但相邻的肝脏、浆膜和血管保持完整。在随访8周的16只动物中的13只中，胆囊腔被纤维瘢痕组织闭塞。在用95%乙醇和3% STS治疗的动物中，2周后（2只动物中的2只）所有区域的胆囊黏膜均坏死，8周后（8只动物中的6只）完全消除；另一种方案（70%乙醇加1% STS）效果稍差。在本研究中，RF介导的胆囊管闭塞与乙醇和STS的胆囊硬化治疗相结合，可在猪中实现胆囊消融且无毒性副作用。
