Experimental Study Of Selective Bile Duct Ablation And Embolization

Background:Hepatolithus is a kind of pigment sendiment. Its pathological changes are very complicated, including stone formation, stricture and dialation of local bile ducts, secretion of epithelia and mucous glands, nerve growth factor formation etc, all of which contribut to the chronic proliferative cholangitis and fibrosis/atrophy of liver. To our knowledge, the treatment of hepatolithiasis should focus on the removal of biliary obstruction, the clearance of lesions and the building of drainage. Although hepatic resection has been widely used in the treatment of hepatolithiasis combined with choledochoscope, the recurrence rate of hepatolithiasis is still high.The outcome of patients with small hepatic ducts stricture is not good. Chronic proliferative cholangitis and the secondary bile duct stricture is the major cause of the high recurrence rate of hepatolithiasis. Hepatobiliary exploration and partial hepatectomy are the major therapeutic ways for hepatolithiasis. Given the complexity of pathogenesis and high risk of surgical procedure, only small amount of hepatobiliary centers can perform this kind of operation. Further more, some patients can't tolerate partial hepatectomy. Thus, the exploration of new therapeutic ways is necessary.Bile duct ablation and embolization (BAE) is a new way for the treatment of hepatolithiasis, which is based on the segmental changes of hepatolithus along with the intrahepatic bile duct system. The biliary obstruction caused by bile stones can lead to atrophy, fibrosis and'self- resection'of corresponding hepatic segments. So, if the bile ducts with lesions could be ablated and embolized by some chemical agents, because there is no bile and space for stone formation in these bile ducts, hepatolithus would not recur theoretically.As we all know, there are only some preliminary studies in BAE. Most of the experiments were performed in small animals, and the effect of BAE on big mammals is not known by far. It's necessary to know the pathological and physiological changes after BAE,...