Povidone Iodine and Hypertonic Saline Induced Sclerosing Cholangitis in Hepatic Hydatid Cysts Surgery
Kerbala Journal of Medicine,
2017, Volume 10, Issue 2, Pages 2680-2686
ackground: Surgery is the treatment of choice for hepatic hydatid disease but surgical treatment carry the risk of recurrence if we do not use a proper scolicidal agent and may convert patient with solitary hepatic hydatid cyst to patient with many incurable cysts. The ideal scolicidal agent should kill vital scolices, and not have local or systemic adverse effect, and not toxic to bile duct. Yet, there is no ideal scolicidal agent involving such effects. One of the important serious complications after instillation of scolicidal agents is sclerosing cholangitis.
Aim: to assess the risk and severity of povidone iodine and hypertonic saline induced sclerosing cholangitis in guinea pigs.
Materials and methods: In this study we used twenty guinea pigs which were divided into two equal groups. In the first group 0.3 ml10% povidone iodine was injected to the biliary tree after clamping then released after five minutes and second group, 0.3 ml 20% hypertonic saline was used.
Four months later on the pig was euthanized by ether and three biopsies taken from the liver and sent for histopathological examination. Afterwards, the liver, gall bladder, the common bile duct and the duodenum were excised in one piece and immediately transferred for cholangiography. Two X-ray films were taken for each specimen in lateral and antero-posterior view after contrast material injection.
Results: in povidone iodine group 8 animals (80%) had sclerosing cholangitis while in hypertonic saline group only 2 animals (20%) had sclerosing cholangitis. This difference between the two groups was statistically significant.
Conclusions: Usage of 10% povidone iodine as a protoscolicidal agent carry high risk of sclerosing cholangitis.
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