Effectiveness of chemical biliary duct embolization for chemical hepatectomy

Abstract

Chemical biliary duct embolization, especially using phenol plus cyanoacrylate, might achieve the effects of chemical hepatectomy.

Chemical bile duct embolization for chemical hepatectomy, long term efficacy and feasibility in rats

“…Selection of an appropriate embolization agent that can complete embolization hepatic ducts of various sizes is the most important factor for successful chemical hepatectomy via CBDE. 5,12 Fu-Yu li, Jing-Qiu Cheng et al 12 suggested that phenol is not only the most efficient sclerosants of gall bladder mucosa, but is also a powerful antiseptic which might not only assist in ameliorating biliary infection which commonly accompanies hepatolithiasis, but also could commendably destroy the biliary mucosa and induced fibrous conglutination in the bile duct lumen, leading to partial occlusion of the large-size and middle-size biliary ducts, and complete occlusion of the small biliary ducts. 18,22,23 However, the biliary system could not be permanently occluded by using phenol or ethanol alone due to the regeneration of biliary mucosa.…”

“…In previous study, we explored the feasibility and efficacy of filling the diseased bile duct with chemical embolization agent to achieve chemical resection of the diseased bile duct and hepatic segment, and was able to establish the effects of chemical hepatectomy only in the periphery of the targeted hepatic lobe. [11][12][13][14][15] This study focuses on whether CBDE in the long-term manages to achieve complete fibrosis, "self-cut" and chemical hepatectomy in the whole embolized hepatic lobe.…”

“…Therefore, hepatic fibrosis process caused by CBDE may progress continuously until complete hepatic fibrosis and "self-cut" chemical hepatectomy is achieved. 12,27,[29][30][31] CBDE for chemical hepatectomy may provide an innovative and less invasive therapeutic approach in treating hepatolithiasis and preventing postoperative recurrences of intrahepatic stones. Chemical hepatectomy of the targeted liver segment is more selective than the traditional hepatectomy, as it can be implicated accurately for subsegmental hepatectomy and preserve significant functional hepatocytes.…”

“…This kind of visibility makes CBDE much safer, easier and more accurate in its application. 5,11,12,15,[23][24][25] The mechanism underlying chemical hepatectomy via CBDE may involve the following aspects. The embolized bile duct obviously distends and compresses the adjacent blood vessels, thus reducing the blood supply to the embolized hepatic lobe.…”

“…However, hepatic atrophy, fibrosis, and "self-cut" phenomenon was only achieved in the peripheral region of the targeted hepatic lobe. 5,[10][11][12][13][14][15] It is still unknown whether hepatic atrophy, fibrosis and "self-cut" phenomenon can be achieved in the whole embolized lobe by CBDE in a longer period of time. Thus, this study was designed to differentiate and explore the efficacy and feasibility of the short-term (6 weeks) and long-term (12 weeks) effects of CBDE to achieve the desired effect of chemical hepatectomy ("self-cut") in the whole targeted hepatic lobe.…”