Povidone iodine versus silver nitrate in induction of sclerosing cholangitis in hepatic hydatid cysts surgery

There are several scolicidal agents for inactivation of hydatid cyst protoscolices during surgery, but most of them are associated with adverse side effects such as sclerosing cholangitis and liver necrosis. The present study aims to evaluate the adverse effects of povidone iodine versus silver nitrate in producing sclerosing cholangitis in animal model. Twenty guinea pigs weighing 250–350 g were used in this study. In one group, 0.3 ml 10% povidone iodine was used for 5 min in the biliary tree while in the second group, 0.3 ml 0.5% silver nitrate was used for the same amount of time. After 4 months, the animals were euthanized, and the livers, common bile ducts, and duodenums were resected and immediately sent for cholangiographic studies. Eight animals showed sclerosing cholangitis in the povidone iodine group (80%), whereas only two showed (20%) sclerosing cholangitis in the silver nitrate group. The difference between the two groups was statistically significant. There was a significant risk of sclerosing cholangitis after administration of 10% povidone iodine as a protoscolicidal agent.