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Pelvic adhesions after gall bladder
surgery
Title: Pelvic adhesion formation after intraperitoneal
installation of
gallstones in a rabbit model
Author: K. Hansen, et al.
Address: Augusta, GA
Source: Fertility and Sterility 72: 868-872 (November) 1999
Summary: To determine if intraperitoneal gallstones increase the risk of
pelvic adhesions in a rabbit model, a prospective, randomized, blinded, sham and
human antigen controlled trial was conducted on 12 white rabbits. The rabbits
were divided into 3 equal groups: a sham operation group, a gallstone and bile
group, and a human serum albumin and bile group. Three weeks after the operation,
necropsy was performed on each rabbit, and the adhesions were scored for extent,
type, tenacity, inflammation, and gallstone involvement. There was a
statistically and biologically significant increase in gallstone involvement in
adhesions, especially pelvic adhesions, in the gallstone and bile group. This
study suggests that gallstones inadvertently left in the peritoneal cavity may
increase the morbidity of laparoscopic cholecystectomy. In females of
reproductive age these gallstones may cause pelvic adhesions which could
interfere with fertility or be associated with pelvic pain.
Comment: With advances (laparoscopic cholecystectomy) come old problems
(pelvic
adhesions) and new worries.
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