Becker C D, Quenville N F, Burhenne H J
Department of Radiology, University of British Columbia, Vancouver, Canada.
Radiology. 1988 Apr;167(1):63-8. doi: 10.1148/radiology.167.1.3347747.
Recurrent cholelithiasis must be expected after gallstone removal without cholecystectomy. Chemical gallbladder ablation may offer prevention but requires preliminary cystic duct occlusion. Radio-frequency (RF) electrocoagulation of the cystic duct was performed in 15 pigs to induce occlusion by a controlled thermal epithelial injury. A flexible coagulation catheter was placed into the cystic duct lumen under fluoroscopic control by means of either subhepatic cholecystostomy or direct, percutaneous transhepatic gallbladder puncture. Complete cystic duct occlusion was proved in 14 animals. Follow-up ranged from 1 to 17 weeks (mean, 11 weeks). Histologically, the RF technique induced an intense chronic inflammatory and fibroblastic reaction, which eventually obliterated the coagulated cystic duct segments. There was no epithelial regeneration or recanalization of the fibrotic cystic duct segments. The adjacent structures, particularly the cystic artery, were intact in all specimens.
在未行胆囊切除术而仅取出胆结石后，复发性胆石症是可以预料到的。化学性胆囊消融术或许可以预防，但需要先行胆囊管闭塞。对15头猪实施了胆囊管的射频（RF）电凝术，通过可控的热上皮损伤诱导闭塞。借助肝下胆囊造口术或直接经皮经肝胆囊穿刺，在透视控制下将一根可弯曲的电凝导管置入胆囊管腔。14只动物证实胆囊管完全闭塞。随访时间为1至17周（平均11周）。组织学检查显示，射频技术引发了强烈的慢性炎症和成纤维细胞反应，最终使电凝的胆囊管节段闭塞。纤维化的胆囊管节段没有上皮再生或再通。所有标本中，相邻结构，尤其是胆囊动脉均完好无损。
