Soulen M C, Sullivan K L
Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia 19104, USA.
J Vasc Interv Radiol. 1995 Jul-Aug;6(4):553-8. doi: 10.1016/s1051-0443(95)71133-2.
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.
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.
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.
Chemical ablation of the pig gallbladder epithelium was not feasible in this experimental model.
已尝试在动物和人类中使用多种化学和物理剂经导管消融胆囊。最初的体外实验表明，氢氧化钠和过氧化氢作为硬化剂比先前报道的化学剂更有效。在体内进行了一项关于这些剂的浓度递增和暴露时间的I期试验。
14头家猪接受胆囊造瘘管置入和胆囊管结扎。两周后，用氢氧化钠/乙醇溶液和过氧化氢进行硬化治疗。
在体内，依次15或30分钟暴露于乙醇中0.1 N的氢氧化钠溶液，然后用3%的过氧化氢处理，未能完全消除猪胆囊上皮；乙醇中0.5 N和1.0 N的氢氧化钠导致胆囊严重出血、壁层剥离和1例穿孔。尽管胆囊腔被消融，但在任何动物中胆囊上皮均未被完全消除。
在该实验模型中，化学消融猪胆囊上皮是不可行的。
