Ablation of the cystic duct and gallbladder: clinical observations.

Becker, Christoph; Fache, J S; Malone, D E; Stoller, J L; Burhenne, H J

doi:10.1148/radiology.176.3.2389027

Cited by 48 publications

(26 citation statements)

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“…Therefore, the effects of acetic acid may be helpful to eliminate the mucosa in Rokitansky-Aschoff sinuses. In addition, these structures can also be ablated after repeated sessions of sclerotherapy, as was performed in some patients as reported by Becker et al (21) and Xu et al (22). In addition, gallbladder wall edema and gallstones usually accompany cholecystitis in a clinical situation, so it must be ensured that this technique will succeed in such conditions.…”

Section: Discussionmentioning

confidence: 94%

“…Becker et al (21) extended the procedure to eight human subjects, occluding the cystic duct by means of endoluminal radiofrequency electrocoagulation and sclerosing the gallbladder with ethanol and sodium tetradecyl sulfate. There were no major complications, but complete elimina- tion of the gallbladder lumen was not achieved in any of the patients.…”

Section: Discussionmentioning

confidence: 99%

“…The possible causes of incomplete ablation of the mucosa in the gallbladder neck are ingrowth of mucosa from the cystic duct or incomplete ablation of the original mucosa caused by inadvertent protection provided by the microcoils and glue that keep the sclerosant from contacting the mucosa. Hence, if cystic duct occlusion had been performed with endoluminal yttrium aluminum garnet laser thermocoagulation as examined by Girard et al (7) or with endoluminal radiofrequency electrocoagulation as performed by Becker et al (21) or Xu et al (22), complete ablation of the entire gallbladder may have occurred.…”

Section: Discussionmentioning

confidence: 99%

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Chemical Ablation of the Gallbladder with Acetic Acid

Lee

Won

Bae

et al. 2009

Journal of Vascular and Interventional Radiology

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PURPOSE: Chemical ablation of the gallbladder may be a useful alternative to surgery for inoperable disease. The purpose of this study was to investigate the feasibility of chemical ablation of the gallbladder with acetic acid in a canine model. MATERIALS AND METHODS:Five beagle dogs underwent percutaneous transhepatic cholecystostomy. Percutaneous occlusion of the cystic duct was performed with use of n-butyl cyanoacrylate (NBCA) and coils. After confirmation of occlusion of the cystic duct, sclerotherapy of the gallbladder was performed with 4 -7 mL of 50% acetic acid through the drainage catheter. Acetic acid was retained for 20 minutes with intermittent position change. The drainage catheter was removed immediately after sclerotherapy. The dogs were euthanized 8 weeks after the procedure. The gallbladders and adjacent organs were evaluated grossly as well as microscopically.RESULTS: All dogs survived without serious complications during the experimental period. Sclerotherapy was technically successful in all dogs. Gross specimens of the gallbladder showed shrinkage and fibrotic change without retention of any bile, mucus, or pus. Histologic examinations from the body and fundus of the gallbladder demonstrated complete ablation of the mucosa. However, the neck region of the gallbladder near the cystic duct, where NBCA and coils for cystic duct occlusion were located, had focal areas of remnant or regenerating mucosa.CONCLUSIONS: Chemical ablation of the gallbladder with 50% acetic acid was effective and safe. Complete ablation was achieved in the majority of gallbladder mucosa except for a small portion located in the gallbladder neck.

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Section: Discussionmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Chemical Ablation of the Gallbladder with Acetic Acid

Lee

Won

Bae

et al. 2009

Journal of Vascular and Interventional Radiology

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“…• RFA -RF microwaves have been successfully used in treating various medical conditions including: ablation of irritable foci in the cardiac conducting system (25), treating endometrial bleeding (26), and ablation of the cystic duct (27). In 1989 Tillotson, Rosenberg and Rosenthal (28) described creation of controlled areas of bone marrow and cortical necrosis ranging from 0.9 cm to 1.3 cm in diameter in the femur of dogs using RFA.…”

Section: Introductionmentioning

confidence: 99%

Femur shaft fracture following osteoid osteoma radiofrequency ablation

Mazzawi

Militianu

Eidelman

et al. 2017

ccmbm

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SummaryIntroduction. Radiofrequency ablation is an effective modality in treating osteoid osteoma while avoiding the complications of an open procedure. Its complications are usually self-limited consisting mostly of local skin burns. This report presents a major complication, a femur shaft fracture following an osteoid osteoma radiofrequency ablation. The fracture occurred approximately one year after the ablation at the site of the osteoid osteoma. Discussion. Few case reports have been published regarding subtrochanteric femur fracture after ablation of an osteoid osteoma. To our knowledge this is the first report of a femoral shaft fracture following an ablation. Another unique characteristic of the presented case is the late presentation, approximately one year following ablation. Factors which may have contributed to the fracture include lateral entry point of the drill which may have weakened the femur when taking its biological and mechanical properties into account, and the fact that the patient was a soldier who was allowed to continue his military training only six weeks after the ablation. Conclusion. Radiofrequency ablation is an effective and relatively safe technique in treating osteoid osteomas, however the physician should be aware of the fracture risk involved, consider mechanical and biologic factors of the bone prior to drilling, and be very conservative when recommending return to high level activity. In addition, a close follow-up should be carried on after the procedure in order to supervise bone remodeling.

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“…In recent decades, experimental studies on chemical ablation of the cystic duct and gallbladder in vitro and in vivo in animals have demonstrated that many sclerosants, such as 95% ethanol, 3% sodium tetradecyl sulfate, 5% tetracycline, and 5% trifluoroacetic acid, function to ablate the gallbladder mucosa [2,11,14]. A few clinical applications and short time of follow-up were reported, and different results were obtained [1,5,10]. In order to investigate whether minicholecystostomy followed by gallbladder ablation may be used as an alternative to cholecystectomy, based on our animal experiments and preliminary clinical observations [15], minicholecystostomy was performed in high-risk patients with cholelithiasis and/or acute cholecystitis, and chemical ablation of the gallbladder in clinical application and long-term observations are reported here.…”

mentioning

confidence: 99%