Most of the progress in the diagnosis and treatment of biliary tract disease has been made in the last century. but the gallstones and their sequelae which cause most of the clinical problems. are not malady of modern times.
Alternatives to traditional cholecystectomy were developed during the 1980s and are currently undue evaluation. They include oral chemolysis. extracorporeal shock wave lithotripsy. percutaneous dissolution and extaction, and laparoscopic cholecystectomy.
One of the goals of interventional surgery is to simplify patient care by performing surgical techniques percutaneously. Cholecysrectomy is one technique that, lends itself to interventioal approach. one acan envision replacing surgery with a four step procedure. 1) percutaneous cholecystostomy 2) percutaneous stone removal 3) sclerosis and fibrosis of the gall bladder 4) cystic duct occlusion.
Both percutaneous cholecystostomy and stone removal have been performed frequently and are in the interventional repertoire. Sclerosis of biliary system may be derived from experience with chemical agents. The aim of this study is a preliminary clinical application of chemical fibrosis of gallbladder with 95% Ethanol and 5% Phenol for treatment of gallbladder diseases.
The following results were obtained:
1) The values of liver function test were normnal on postoperative 1 day. 1 week and 4 weeks in cystic duct ligated control group.
2) AST, ALT and ALP were increased markedly on postoperative 1 day after 10, 30 and 60 minutes injection groups into gallbladder with both 95% ethanol and 5% phenol.
3) The edema, congestion and inflammatory changes of gallbladder were mildly developed on postoperaive 1 day. 1 week and 4 weeks in 10, 30, and 60 minutes cystic duct ligated control group.
4) The fibrosis of gallbladder was moderately to severely developed on postoperative 4 weeks after 10, 30 and 60 minutes injection group into gallbladder with 95% ethanol.
5) The fibrosis of gallbladder was moderately developed on postoperative 4 weeks after 10, 30 and 60 minutes injection group into gallbladder with 5% phenol.
Inspite of a limited number of observation, the chemical sclerosing agents may be useful treatmental method for gallstone patient if applied in selected cases and it should he opened for further study in lager experimental group.
