Sclerosing Cholangitis Induced by Intra-Biliary Tree Injection of Silver Nitrate or Hypertonic Saline Solutions in Rabbit

Background: One of the most serious late complications, after evacuation of liver hydatid cyst and instillation of scolicidal agents is sclerosing cholangitis, most probably caused by the type of scolicidal agents instilled. Objective:  To determine the incidence of sclerosing cholangitis after intra-biliary tract infusion of 5% saline and 0.5% silver nitrate. Methods: 5% hypertonic saline and 0.5% silver nitrate were injected trans-hepatically into the gallbladder of two equal groups (n=15/group) of rabbits.  4 months later, the livers were biopsied and cholangiography was performed, investigating for signs of sclerosing cholangitis (SC).  Results: 30% of the rabbits in group A (hypertonic saline) and 80% of group B (silver nitrate) developed SC. The prevalence of SC and also the severity of pathological findings were significantly (p<0.05) higher in group B (silver nitrate).  5% hypertonic saline seems to cause a significant amount of sclerosis. Conclusions:  For treatment of hydatid cyst, intra-cystic injection of 5% hypertonic saline or 0.5% silver nitrate is not safe.