Bile duct scarring following ethanol embolization of the hepatic artery: an experimental study in monkeys

Alcohol is a popular embolizing agent, especially in renal tumors and esophageal varices, and results of its use are encouraging. Alcohol embolization of hepatic tumors offers theoretic protection of hepatocytes by portal venous dilution. To verify this, we performed hepatic artery embolization in six adult Rhesus monkeys by alcohol infusion. Although injury to liver cells was minimal, we observed severe damage to intrahepatic bile ducts. Our experience showed that alcohol in the hepatic artery perfused the peribiliary plexus and produced scarring of the bile ducts, resulting in a cholangiographic picture that resembled that of sclerosing cholangitis. Further studies are necessary before alcohol is recommended for hepatic embolization.