Sclerotherapy of the gallbladder in pigs. Development of a balloon catheter for a single-step procedure.
Gallbladder sclerotherapy after permanent cystic duct occlusion, to prevent gallstone recurrence in nonsurgical gallstone therapy, is at least a two-stage procedure. A balloon catheter was developed to perform gallbladder sclerotherapy with only temporary occlusion of the cystic duct, and the efficacy and safety of this method was subsequently investigated. Twenty pigs underwent cholecystostomy for positioning of a 7-Fr triple-lumen balloon catheter with proximal side holes. Sclerotherapy with 96% ethanol and 3% sodium tetradecyl sulfate for 20 minutes was performed. The animals were killed 24 hours, two, six, and 12 weeks after the procedure. The balloon catheter functioned well and seems suitable for procedures in which a temporary occlusion of the cystic duct is required. Although gallbladders after six and 12 weeks were shrunken and fibrotic, a single treatment of gallbladder sclerotherapy with subsequent catheter removal and no permanent cystic duct occlusion, as performed in this experiment, did not produce complete gallbladder ablation. In this study, sclerotherapy proved safe in the short term, but long-term effects remain to be assessed.
Brakel
K
K
Department of Radiology, University Hospital Dijkzigt, Erasmus University Rotterdam, The Netherlands.
Laméris
J S
JS
Vergunst
H
H
Ten Kate
F J
FJ
Nijs
H G
HG
Terpstra
O T
OT
D000818:Animals; D002404:Catheterization / Q000295:instrumentation*; D002769:Cholelithiasis / Q000517:prevention & control; D003549:Cystic Duct / Q000000981:diagnostic imaging; D005704:Gallbladder / Q000473:pathology; D015641:Radiography, Interventional / Q000295:instrumentation; D012008:Recurrence; D015911:Sclerotherapy / Q000295:instrumentation / Q000379:methods; D013552:Swine