OP 141. Consequences of Lost Gallstones in the Abdominal Cavity after Laparoscopic Colecystectomy-Randomized Experimental Animal Study


B. Lévay, G. Szabó, V. Nagy, C. Nyakas, M. Sasváry, A. Szijártó, G. Eldin Mohamed

Chair(s): Robert Langer, Stefan Manekeller & Zoltán Czigány

15:30 - 15:40h at Pest Room (C)

Categories: Hepatobiliary and Pancreatic Surgery, Oral Session

Session: Oral Session XVI - Hepatobiliary and Pancreatic Surgery II


Background
LC became the standard technique for the removal of the gallbladder containing stones. During surgery mechanical perforation of the gallbladder can occur, which results in the loss of some of the gallstones in the abdominal cavity. The aim of this study is to detect the behavior of the different types of the lost gallstones and to examine the effect of topically applied antibiotic lavage.

Materials and Methods
75 Wistar rats were used. Following median laparotomy human sterile, contaminated gallstones and artificial cholesterol pills were placed in each rat in different regions in the abdominal cavity. In one group antibiotic lavage was applied. On the 42th postoperative day, specimens were taken from the surrounding tissues of each gallstone for histology followed by extermination .The inflammations in the samples were classified into three groups by the help of inflammatory cells and reactions occurring in the tissue sections: gentle, moderate, serious.

Result
To compare the experimental groups : inflammation depended on the type of the gallstones . Sterile, artificial cholesterol pills did not cause any complications. Human gallstones caused serious inflammation ,abscess formation independently of their contamination . Contaminated gallstones with antibiotic lavage decreased the inflammation reaction in the surrounding tissues. In the sterile cholesterol inserted group and in the antibiotic lavage applied group only gentle and moderate inflammation could be observed.

Conclusion
Human gallstones proved to have the effect of massive inflammation and abscess-formation. This effect significantly decreased with the use of antibiotic lavage. The best solution is to remove lost gallstones from the abdominal cavity.