Cline R W, Poulos E, Clifford E J
Department of Surgery, St. Paul Medical Center, Dallas, Texas 75235.
Am Surg. 1994 May;60(5):303-5.
Perforation of the gallbladder with spillage of stones into the peritoneal cavity occurs frequently during laparoscopic cholecystectomy. In order to study the effects of these stones, the authors placed no gallstones (Group I, n = 6), one stone (Group II, n = 12), or five stones (Group III, n = 12) within the peritoneal cavity of Sprague-Dawley rats. One-third of the animals in each group were then killed at intervals of 2, 4, and 8 weeks. At necropsy, the location of each stone was noted as well as any evidence of adhesion, fistula, perforation, or obstruction. No difference between groups with respect to presence of adhesions, density of adhesions, or stone location was noted, though there was a trend toward more stones becoming fixed within the abdomen over time. Perforation of the gallbladder with spillage of sterile stones does not appear to cause increased morbidity during or after laparoscopic cholecystectomy.
在腹腔镜胆囊切除术中，胆囊穿孔伴结石落入腹腔的情况屡见不鲜。为研究这些结石的影响，作者在斯普拉格-道利大鼠的腹腔内分别置入无结石（I组，n = 6）、1枚结石（II组，n = 12）或5枚结石（III组，n = 12）。然后，每组三分之一的动物分别在2周、4周和8周时处死。尸检时，记录每枚结石的位置以及粘连、瘘管、穿孔或梗阻的任何证据。尽管随着时间推移有更多结石在腹腔内固定的趋势，但在粘连的存在、粘连的密度或结石位置方面，各组之间未发现差异。无菌结石溢出导致的胆囊穿孔似乎不会在腹腔镜胆囊切除术期间或术后增加发病率。
