Sclerotherapy of Edematous Gallbladders with Different Agents

Abstract

Different sclerosing agents were tried in experiments with 32 pigs to achieve ablation of gallbladders rendered edematous by mechanical lithotripsy with the Rotolith Iithotriptor. In 16 pigs sclerotherapy was performed with 6% acetic acid, Carnoy's solution, 95°/<, ethanol + 3'X, sodium-tetradecylsulfate (STS) and hot metrizoate, respectively. These animals were sacrificed immediately after the procedure. Histologic examination showed persistent surface epithelium and glandular epithelium in all specimens. In 6 pigs, the sclerotherapy was done with Carnoy's solution, 95% ethanol + 3% STS and hot metrizoate, respectively, and the pigs were killed 6 days later. Fibrosis of the gallbladder remnants was seen in these animals, but also remnants of surface and glandular epithelium. Hot metrizoate was used in another 10 pigs and these animals were sacrificed after 8 weeks. At histologic examination fibrosis was seen in the gallbladder remnants of 9 surviving animals, but also areas of preserved muscular layer, and development of mucinous cysts were found in more than 50% of the specimens. Thus, none of the sclerosants was able to produce a total ablation of the gallbladder mucosa.

Gallbladder Drainage: IR and GI Perspective

“…Many chemical agents were tried in an effort to denude the gallbladder mucosa, including ethanol, sodium tetradecyl sulfate, trifluoroacetic acid, phenol, ethylenediaminetetraacetic acid (EDTA), hydrogen peroxide, n-butyl cyanoacrylate (NBCA) glue, tetracycline, ethanol, boiling contrast, and acids. [35][36][37][38][39][40][41][42][43][44][45] For years, these efforts were unsuccessful, largely due to the mucosa being very resistant to damage, leading to regrowth of the mucosa and eventual mucocele. 46 In 2020, a small retrospective trial of 10 patients with cholecystostomy tubes was reported in which the patients' gallbladders were sclerosed with 3% Aethoxysklerol after coil embolization of the cystic duct.…”