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An experimental study of selective intrahepatic biliary ablation with ethanol
1First Department of Surgery, Nagoya University School of Medicine, 65 Tsurumai-cho, Syowa-ku, Nagoya, 466-8550, Japan. tkyokane@med.nagoya-u.ac.jp
Background:
Few attempts have been made to investigate the feasibility of selective intrahepatic biliary ablation with absolute ethanol.
Methods:
Through a catheter cannulated into the bile duct of the left lateral and median lobes (70% of total liver weight), 0.2 mL of absolute ethanol was injected into rats.
Results:
The weight of the infused lobes decreased to less than 50% of the entire liver weight 14 days after treatment, while the weight of the noninfused lobes increased to 1.6-fold of the original value. This increase was associated with a markedly elevated Ki-67 labeling index. Both bile flow and bile acid excretion in the noninfused lobes significantly increased to more than twice the original values on Day 14. Histologically, the interlobular bile ducts of the infused lobes were destroyed. Ethanol also soaked through Glisson's capsule and destroyed hepatocytes, which were replaced by fibrous tissue and proliferating bile ductules without necrosis by Day 14. The portal veins and hepatic arteries supplying the infused lobes were structurally well preserved throughout the study period.
Conclusion:
Selective biliary infusion of ethanol can be performed safely without serious complications, achieving lobar ablation with contralateral hypertrophy of the liver.