Radiology, Vol 167, 63-68, Copyright © 1988 by Radiological Society of North America
Long-term occlusion of the porcine cystic duct by means of endoluminal radio-frequency electrocoagulation
CD Becker, NF Quenville and HJ Burhenne
Department of Radiology, University of British Columbia, Vancouver, Canada.
Recurrent cholelithiasis must be expected after gallstone removal without
cholecystectomy. Chemical gallbladder ablation may offer prevention but
requires preliminary cystic duct occlusion. Radio- frequency (RF)
electrocoagulation of the cystic duct was performed in 15 pigs to induce
occlusion by a controlled thermal epithelial injury. A flexible coagulation
catheter was placed into the cystic duct lumen under fluoroscopic control
by means of either subhepatic cholecystostomy or direct, percutaneous
transhepatic gallbladder puncture. Complete cystic duct occlusion was
proved in 14 animals. Follow-up ranged from 1 to 17 weeks (mean, 11 weeks).
Histologically, the RF technique induced an intense chronic inflammatory
and fibroblastic reaction, which eventually obliterated the coagulated
cystic duct segments. There was no epithelial regeneration or
recanalization of the fibrotic cystic duct segments. The adjacent
structures, particularly the cystic artery, were intact in all specimens.
