| Budget Amount *help |
¥2,500,000 (Direct Cost: ¥2,500,000)
Fiscal Year 1992: ¥500,000 (Direct Cost: ¥500,000)
Fiscal Year 1991: ¥500,000 (Direct Cost: ¥500,000)
Fiscal Year 1990: ¥1,500,000 (Direct Cost: ¥1,500,000)
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| Research Abstract |
Cholecystectomy is one of the commonest surgical operations of the abdomen. The major reason for this operation is cholecystitis associated with gallbladder srtones. Thanks to therecent progress of Interventional Radiology (percutaneous procedure under radiological guidance replacing conventional surgery), we are now able to take out almost any gallstone in the biliary tree. However, as far as gallbladder remains, possibilities of recurrence of gallstones and cholecystitis cannot be avoided. Thus, we made fundamental and clinical study of gallbladder ablation, might which lead to the permanent freedom from recurrent gallbladder stones.
We injected absolute alcohol and ethoxysclerol into the gallbladders of the anesthesized rabbits after aspirating the contents of the gallbladders. After 1 to 2 weeks,laparotomy was performed again, gallbladder and adjacent liver were resected, and macroscopic and histological study were performed. In results, absolute ethanol showed very strong ability t
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o destroy gallblader mucosa when the mucosa was fully exposed to alcohol. However, when there remained intact survived gallbladder mucosa around the cystic duct, regeneration of the mucosa extended from there and gallbladder ablation could not be completed. Therefore, complete closure of the cystic duct was considered to be indispensable for gallbladder ablation. Then, we tried experimental cystic duct closures, and found out that electrocoagulation of the cystic ducts easily and permanently close the duct.
Gallbladder ablation was performed for four patients with inoperable advanced abdominal malignancy associated with gallbladder hydrops and cholecystitis for the purpose of the preventing recurrent gallbladder symptoms. Successful prevention of recurrent gallbladder troubles was achieved in all the cases. However, complete disappearance of gallbladder cavity or entire scarring of the gallbladder was not obtained.
Finally we made experimental studies on gallbladder ablation using hot water. The effect of hot water to the gallbladder was potent enough to expect permanent gallbladder ablation. How-ever, adjacent liver undertook thermal injury at the same time, and further study to estimate the best balance of safety and efficacy was considered to be necessary. Less
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