Pelvic adhesion formation after intraperitoneal installation of gallstones in a rabbit model.
OBJECTIVE
To investigate whether intraperitoneal gallstones increase the risk of pelvic adhesions in a rabbit model.


METHODS
Prospective, randomized, blinded, sham and human antigen controlled trial.


METHODS
An academic research environment.


METHODS
Twelve New Zealand white rabbits.


METHODS
Twelve rabbits were divided into three groups of four each; a sham operation group, a gallstone and bile group (study group), and a human serum albumin and bile group (antigenic control). Three weeks after the operation individual subjects were randomized, with groups concealed to observers, and a necropsy was performed on each rabbit.


METHODS
Necropsy was performed on each rabbit, and the adhesions were scored for extent, type, tenacity, inflammation, and gallstone involvement.


RESULTS
There was a statistically and biologically significant increase in gallstone involvement in adhesions, especially pelvic adhesions, in the study group.


CONCLUSIONS
This study, along with an increasing number of case reports, suggests that gallstones inadvertently left in the peritoneal cavity may increase the morbidity of laparoscopic cholecystectomy. In females of reproductive age these gallstones may induce pelvic adhesions that may interfere with fertility or be associated with pelvic pain.
Hansen
K A
KA
Department of Obstetrics and Gynecology, Medical College of Georgia, Augusta, USA. kahansen@usd.edu
Lowman
L
L
Fiedler
E P
EP
Tho
S P
SP
Martindale
R
R
McDonough
P G
PG
D000818:Animals; D000941:Antigens / Q000276:immunology; D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects*; D002769:Cholelithiasis / Q000473:pathology*; D004195:Disease Models, Animal; D006801:Humans; D010388:Pelvis / Q000473:pathology; D010529:Peritoneal Cavity; D011817:Rabbits; D000267:Tissue Adhesions / Q000209:etiology*
D000941:Antigens