Top

Annals of Surgical Innovation and Research

Published in:

Open Access 01-12-2010 | Research article

Internal gallbladder drainage prevents development of acute cholecystitis in a pig model: a randomized study

Authors: Daniel W Kjaer, Frank V Mortensen, Jens K Møller, Stephen J Hamilton-Dutoit, Peter Funch-Jensen

Published in: Annals of Surgical Innovation and Research | Issue 1/2010

Abstract

Background

Acute cholecystitis can be the result of retention of bile in the gallbladder with possible secondary infection and ischaemia. The aim of the present study was to investigate whether internal drainage of the gallbladder could protect against the development of acute cholecystitis in a pig model.

Materials and methods

Twenty pigs were randomized to either internal drainage (drained) or not (undrained). Day 0 acute cholecystitis was induced by ligation of the cystic artery and duct together with inoculation of bacteria. Four days later the pigs were killed and the gallbladders were removed and histologically scored for the presence of cholecystitis. Bile and blood samples were collected for bacterial culturing and biochemical analyses.

Results

The histological examination demonstrated statistical significant differences in acute cholecystitis development between groups, the degree of inflammation being highest in undrained pigs. There were no differences in bacterial cultures between the two groups.

Conclusion

Internal drainage of the gallbladder protected against the development of acute cholecystitis in the present pig model. These findings support the theory that gallstone impaction of the cystic duct plays a crucial role as a pathogenetic mechanism in the development of acute cholecystitis and suggest that internal drainage may be a way to prevent and treat acute cholecystitis.

Available only for authorised users

Barbara L, Sama C, Morselli Labate AM, Taroni F, Rusticali AG, Festi D, Sapio C, Roda E, Banterle C, Puci A: A population study on the prevalence of gallstone disease: the Sirmione Study. Hepatology 1987, 7(5):913–917. 10.1002/hep.1840070520CrossRefPubMed

The National Patient Registry2008. [http://www.sst.dk/Indberetning%20og%20statistik/Forskerservice.aspx]

Borzellino G, de Manzoni G, Ricci F, Castaldini G, Guglielmi A, Cordiano C: Emergency cholecystostomy and subsequent cholecystectomy for acute gallstone cholecystitis in the elderly. Br J Surg 1999, 86(12):1521–1525. 10.1046/j.1365-2168.1999.01284.xCrossRefPubMed

Werbel GB, Nahrwold DL, Joehl RJ, Vogelzang RL, Rege RV: Percutaneous cholecystostomy in the diagnosis and treatment of acute cholecystitis in the high-risk patient. Arch Surg 1989, 124(7):782–785.CrossRefPubMed

Hadas-Halpern I, Patlas M, Knizhnik M, Zaghal I, Fisher D: Percutaneous cholecystostomy in the management of acute cholecystitis. Isr Med Assoc J 2003, 5(3):170–171.PubMed

Stage JG, Rasmussen SG, Hojgaard L, Kehlet H: Percutaneous cholecystectomy in acute cholecystitis. Ugeskr Laeger 1993, 155(43):3477–3480.PubMed

Spira RM, Nissan A, Zamir O, Cohen T, Fields SI, Freund HR: Percutaneous transhepatic cholecystostomy and delayed laparoscopic cholecystectomy in critically ill patients with acute calculus cholecystitis. Am J Surg 2002, 183(1):62–66. 10.1016/S0002-9610(01)00849-2CrossRefPubMed

Andren-Sandberg A, Haugsvedt T, Larssen TB, Sondenaa K: Complications and late outcome following percutaneous drainage of the gallbladder in acute calculous cholecystitis. Dig Surg 2001, 18(5):393–398. 10.1159/000050180CrossRefPubMed

Hamy A, Visset J, Likholatnikov D, Lerat F, Gibaud H, Savigny B, Paineau J: Percutaneous cholecystostomy for acute cholecystitis in critically ill patients. Surgery 1997, 121(4):398–401. 10.1016/S0039-6060(97)90309-3CrossRefPubMed

10.

Kjaer DW, Kruse A, Funch-Jensen P: Endoscopic gallbladder drainage of patients with acute cholecystitis. Endoscopy 2007, 39(4):304–308. 10.1055/s-2007-966335CrossRefPubMed

11.

Itoi T, Sofuni A, Itokawa F, Tsuchiya T, Kurihara T, Ishii K, Tsuji S, Ikeuchi N, Tsukamoto S, Takeuchi M, Kawai T, Moriyasu F: Endoscopic transpapillary gallbladder drainage in patients with acute cholecystitis in whom percutaneous transhepatic approach is contraindicated or anatomically impossible (with video). Gastrointest Endosc 2008, 68(3):455–460. 10.1016/j.gie.2008.02.052CrossRefPubMed

12.

Ogawa O, Yoshikumi H, Maruoka N, Hashimoto Y, Kishimoto Y, Tsunamasa W, Kuroki Y, Yasuda H, Endo Y, Inoue K, Yoshiba M: Predicting the success of endoscopic transpapillary gallbladder drainage for patients with acute cholecystitis during pretreatment evaluation. Can J Gastroenterol 2008, 22(8):681–685.PubMedCentralPubMed

13.

Siegel JH, Kasmin FE, Cohen SA: Endoscopic retrograde cholangiopancreatography treatment of cholecystitis: possible? Yes; practical? Diagn Ther Endosc 1994, 1(1):51–56. 10.1155/DTE.1.51PubMedCentralCrossRefPubMed

14.

Pannala R, Petersen BT, Gostout CJ, Topazian MD, Levy MJ, Baron TH: Endoscopic transpapillary gallbladder drainage: 10-year single center experience. Minerva Gastroenterol Dietol 2008, 54(2):107–113.PubMed

15.

den Hoed PT, Boelhouwer RU, Veen HF, Hop WC, Bruining HA: Infections and bacteriological data after laparoscopic and open gallbladder surgery. J Hosp Infect 1998, 39(1):27–37. 10.1016/S0195-6701(98)90240-7CrossRefPubMed

16.

Teixeira JP, Malheiro L, Pontinha N, Frioes F, da Fonseca F, Saleiro V, Saraiva AC: Infectious factors in acute acalculous cholecystitis. Hepatogastroenterology 2002, 49(48):1484–1486.PubMed

17.

Warren BL: Small vessel occlusion in acute acalculous cholecystitis. Surgery 1992, 111(2):163–168.PubMed

18.

Shaked G, Ovnat A, Eyal A, Fraser D, Klain J, Peiser J, Charuzi I: Acute acalculous cholecystitis--experimental and clinical observations. Isr J Med Sci 1988, 24(8):401–404.PubMed

19.

Parkman HP, Bogar LJ, Bartula LL, Pagano AP, Thomas RM, Myers SI: Effect of experimental acalculous cholecystitis on gallbladder smooth muscle contractility. Dig Dis Sci 1999, 44(11):2235–2243. 10.1023/A:1026600603121CrossRefPubMed

20.

Lee FT Jr, DeLone DR, Bean DW, Broghammer BG, Mack E, Perlman SB, Weiss JW: Acute cholecystitis in an animal model: findings on color Doppler sonography. AJR Am J Roentgenol 1995, 165(1):85–90.CrossRefPubMed

21.

Myers SI, Haley-Russell D, Parks L, Husband K: Common bile duct ligation in rabbit: a new model of acute cholecystitis description of histology and bile analysis. J Surg Res 1988, 45(6):556–564. 10.1016/0022-4804(88)90144-8CrossRefPubMed

22.

Cole WH, Novak MV, Hughes EO: Experimental production of chronic cholecystitis by obstructive lesion of the cystic duct. Ann Surg 1941, 114(4):682–696.PubMedCentralCrossRefPubMed

Title: Internal gallbladder drainage prevents development of acute cholecystitis in a pig model: a randomized study
Authors: Daniel W Kjaer
Frank V Mortensen
Jens K Møller
Stephen J Hamilton-Dutoit
Peter Funch-Jensen
Publication date: 01-12-2010
Publisher: BioMed Central
Published in: Annals of Surgical Innovation and Research / Issue 1/2010
Electronic ISSN: 1750-1164
DOI: https://doi.org/10.1186/1750-1164-4-4

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Internal gallbladder drainage prevents development of acute cholecystitis in a pig model: a randomized study

Abstract

Background

Materials and methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Materials and methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 1/2010

An animal paired crossover ePTFE arteriovenous graft model

Feasibility of breast conservation after neoadjuvant taxene based chemotherapy in locally advanced breast cancer: a Prospective Phase I trial

Robotics versus laparoscopy - an experimental study of the transfer effect in maiden users

An effective and safe innovation for the management of vault prolapse

A comparison of perioperative outcomes of Video-Assisted Thoracic Surgical (VATS) Lobectomy with open thoracotomy and lobectomy: Results of an analysis using propensity score based weighting

Vascular clamping in liver surgery: physiology, indications and techniques