CHEMICAL ABLATION OF THE GALLBLADDER

Background Chemical ablation of the gallbladder might avoid the need f or surgery in elderly, unfit patients. This study examined the efficac y of various chemicals in destroying gallbladder mucosa. Methods Ninet y-five per cent ethanol, 3 per cent sodium tetradecyl sulphate (STD), trifluoroacetic acid (TFA) 2 mol/l, tetracycline 50 mg/ml, 30 and 50 p er cent phenol, and a mucosal exfoliant solution (compound ethylene di amine tetra-acetic acid) were tested for gallbladder ablation in rabbi ts. Histology was obtained 8 weeks after exposure to these chemicals. Results Thirty per cent phenol, tetracycline, TFA and ethanol when use d as single agents were moderately effective in causing complete gallb ladder mucosal obliteration, 50 per cent phenol caused a macroscopic b urn of the entire gallbladder. The mucosal exfoliant solution and STD on their own did not cause mucosal destruction but had significantly e nhanced efficacy when combined with 95 per cent ethanol, allowing reli able mucosal destruction with a 5-min contact duration. Conclusion Nin ety-five per cent ethanol and STD after pretreatment with a mucosal ex foliant solution may be the combination of choice for in situ gallblad der mucosal ablation.