Histopathological examination of the impact of sodium hypochlorite on the hepatobiliary system. An experimental study

Abstract

BACKGROUND: The liver is the most common organ for settlement of hydatic cyst disease. All acknowledged protoscolicidals that are used for echinococcus degeneration have a risk of caustic secondary sclerosing cholangitis. The sodium hypochlorite is an effective protoscolicidal agent for treatment of hydatid liver cysts in vitro.

OBJECTIVE: This study aimed to investigate the safe usability of sodium hypochlorite for the treatment of hydatid cyst in the hepatobiliary system in an experimental rat model.

METHODS: This experimental study designed as one side blinded animal study. Study was carried out between October 2017 and August 2018. Rats were randomly allocated to the study (n=7), control (n=7), and sham (n=7) groups. A duodenotomy was performed, and a catheter was inserted through the ampulla. The tip of the catheter was placed to instill 0.15 ml sodium hypochlorite (0,25%) solution, and 0.15 ml isotonic saline solution were into the common bile duct in the study and control groups, respectively. After three months, all rats were sacrificed. Livers, biliary tracts, pancreas, and duodenum were investigated for histopathological changes by blinded two pathologists.

RESULTS: No significant difference was found between groups for periductal portal inflammation (p=0.077), parenchymal inflammation, and focal necrosis (p=0.119). There was not any histopathological change in 71.4 % of the subjects in control and experimental groups.

CONCLUSION: Sodium hypochlorite (0,25%) did not cause any unfavorable changes in the hepatobiliary system, and this reminds that sodium hypochlorite can be a safe alternative in percutaneous drainage, laparoscopic, and open surgery in the treatment of hydatid cyst.