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Spilt bile and gallstones effect during laparoscopic cholecystectomy: an experimental study for adhesion formation

  • Sedigheh Tahmasebi
  • Shahram Jamshidi
  • Nader Tanideh
  • Mohammad Yasin KaramiEmail author
Original Article
  • 17 Downloads

Abstract

Laparoscopic cholecystectomy (LC) is recognized as the standard treatment for symptomatic gallstone disease. In comparison with open techniques, LC results in a higher rate of iatrogenic biliary tract damage and spillage of bile and stones. The present study was designed to compare intraperitoneal adhesion formation following LC due to the bile and stone spillage. In this randomized experimental study, 15 dogs were randomly allocated to three groups. Each group contained five dogs. The control group underwent LC, while in the group of bile and stone spillage (BS), 5 cc of a mixture of dog bile and a sterile ground human gallstone was placed in the bed of the gallbladder following LC. The bile spillage (B) group underwent LC, followed by adding 5 cc of the bile in the bed of the gallbladder. Postsurgical adhesion formation was measured, using Nair and Zühlke classifications for inflammation, fibrosis, and neovascularization. Adhesion formation was noted in one dog from the control and B groups, whereas all animals in group 2 were found to develop high-grade adhesion. Bile cultures were negative for the control group and group B with adhesion. Based on the findings, bile spillage, as well as gallbladder stone spillage, is related to a significant increase in adhesion formation after LC. Therefore, it is necessary to avoid the bile and stone spillage.

Keywords

Laparoscopic Cholecystectomy Adhesion Stone Bile 

Notes

Acknowledgements

We express our gratitude to Shiraz University of Medical Sciences, as well as the Center for Clinical Research Development of Nemazee Hospital. We also thank Dr. Nasrin Shokrpour for her editorial assistance. This study was extracted from a thesis by Dr. Shahram Jamshidi.

Funding information

This study was funded by Shiraz University of Medical Sciences (No. 90-02-012-2352).

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All applicable international, national, and/or institutional guidelines for the care and use of animals were followed. The ethics committee of Shiraz University of Medical Sciences approved the study protocols (IR.SUMS.REC.1390.2352).

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Copyright information

© Springer-Verlag London Ltd., part of Springer Nature 2019

Authors and Affiliations

  1. 1.Breast Diseases Research Center, Department of Surgery, School of MedicineShiraz University of Medical SciencesShirazIran
  2. 2.Department of Plastic and Reconstructive Surgery, School of MedicineIran University of Medical SciencesTehranIran
  3. 3.Stem Cell and Transgenic Technology Research Center, School of MedicineShiraz University of Medical SciencesShirazIran

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