Pelvic adhesion formation after intraperitoneal installation of gallstones in a rabbit model
Pelvic adhesion formation after intraperitoneal installation of gallstones in a rabbit model
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DOI：
10.1016/s0015-0282(99)00398-2
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发表时间：
1999-11-01
影响因子：
6.7
通讯作者：
McDonough, PG
中科院分区：
文献类型：
--
作者：
Hansen, KA;Lowman, L;McDonough, PG
目的：探讨腹腔内胆结石是否会增加兔盆腔粘连的发生风险。设计：前瞻性、随机、盲法、假试验和人抗原对照试验。环境：学术研究环境。实验对象：12只新西兰白兔。干预：12只兔子分为3组，每组4只；假手术组、胆结石及胆汁组（研究组）、人血清白蛋白及胆汁组（抗原对照）。术后3周，随机选取个体，对观察对象进行分组，并对每只兔进行尸检。主要结果测量：对每只兔子进行尸检，并对粘连的程度、类型、韧性、炎症和胆结石累及程度进行评分。结果：研究组中胆结石累及粘连（尤其是盆腔粘连）的发生率在统计学和生物学上均有显著增加。结论：本研究以及越来越多的病例报告表明，无意中遗留在腹腔的胆结石可能会增加腹腔镜胆囊切除术的发病率。在育龄女性中，这些胆结石可引起盆腔粘连，从而影响生育能力或伴有盆腔疼痛。Fertil Sterile(R) 1999；72:868-72 (C) 1999年由美国生殖医学学会出版。
Objective: To investigate whether intraperitoneal gallstones increase the risk of pelvic adhesions in a rabbit model.Design: Prospective, randomized, blinded, sham and human antigen controlled trial.Setting: An academic research environment.Subject(s): Twelve New Zealand white rabbits.Intervention(s): 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.Main Outcome Measurement(s): Necropsy was performed on each rabbit, and the adhesions were scored for extent, type, tenacity, inflammation, and gallstone involvement.Result(s): There was a statistically and biologically significant increase in gallstone involvement in adhesions, especially pelvic adhesions, in the study group.Conclusion(s): 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. (Fertil Sterile(R) 1999;72:868-72 (C) 1999 by American Society for Reproductive Medicine.).