title: Is cetrimide-chlorhexidine risky for secondary sclerosing cholangitis?
abstract: BACKGROUND
  The liver is the most frequent organ for placement of hydatid cyst disease. All known protoscolicidals that are used for echinococcus degeneration have a risk of caustic secondary sclerosing cholangitis. The cetrimide-chlorhexidine combination is an effective protoscolicidal agent for treatment of hydatid liver cysts.
  
  
  OBJECTIVE
  The aim of this experimental study was to examine this combination for potential risks of caustic secondary sclerosing cholangitis.
  
  
  METHODS
  Thirty rats were enrolled and divided into two groups. In the study group, 0.15 mL of a cetrimide (0.5%) and chlorhexidine (0.05%) combination was injected into the bile ducts for five minutes. The control group included the same amount of normal saline and waiting period. The rats were followed for 120 days and the living rats were examined for biliary injury by biochemical analysis and histopathology.
  
  
  RESULTS
  No specific histopathological findings for caustic sclerosing cholangitis such as bile duct stricture or periductal fibrosis were present in any groups. Other pathological criteria demonstrating inflammation including portal inflammation, bile duct proliferation and necrosis were similar in both groups. Biochemical analysis including a liver function test (aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase, gamma-glutamyltranspeptidase) appeared similar to the control group.
  
  
  CONCLUSIONS
  A cetrimide 0.5% and chlorhexidine 0.05% combination has similar liver function results and histopathological effects to normal saline on bile ducts and it appears to be safe for bile ducts.
authors: Inonu University, Turgut Ozal Medical Center, Department of General Surgery, Malatya, Turkey.
authors: Cemalettin
authors: C
authors: Aydin
authors: Inonu University, Turgut Ozal Medical Center, Department of General Surgery, Malatya, Turkey.
authors: Cuneyt
authors: C
authors: Kayaalp
authors: Turkey Yuksek Ihtisas Hospital, Department of Gastrointestinal Surgery, Ankara, Turke.
authors: Gurel
authors: G
authors: Nessar
authors: Turkey Yuksek Ihtisas Hospital, Department of Gastrointestinal Surgery, Ankara, Turke.
authors: Neslihan
authors: N
authors: Zengin
authors: Gulhane Military Medicine Academy, Department of General Surgery, Ankara, Turkey.
authors: Mujdat
authors: M
authors: Balkan
authors: Inonu University, Turgut Ozal Medical Center, Department of General Surgery, Malatya, Turkey.
authors: Bulent
authors: B
authors: Unal
authors: Gulhane Military Medicine Academy, Department of General Surgery, Ankara, Turkey.
authors: Taner
authors: T
authors: Ozgurtas
mesh_terms: D000818:Animals; D000890:Anti-Infective Agents / Q000633:toxicity*; D001652:Bile Ducts / Q000187:drug effects* / Q000473:pathology; D049109:Cell Proliferation / Q000187:drug effects; D000077286:Cetrimonium; D002593:Cetrimonium Compounds / Q000633:toxicity*; D002710:Chlorhexidine / Q000633:toxicity*; D015209:Cholangitis, Sclerosing / Q000139:chemically induced* / Q000473:pathology; D004338:Drug Combinations; D005260:Female; D008111:Liver Function Tests; D009336:Necrosis; D051381:Rats; D017207:Rats, Sprague-Dawley; D013997:Time Factors
chemical_list: D000890:Anti-Infective Agents; D002593:Cetrimonium Compounds; D004338:Drug Combinations; D002710:Chlorhexidine; D000077286:Cetrimonium