Please use this identifier to cite or link to this item: https://hdl.handle.net/11499/5050
Title: Role of a hyaluronic-acid derivative in preventing surgical adhesions and abscesses related to dropped bile and gallstones in an experimental model
Authors: Aytekin, Faruk Önder
Tekin, K.
Kabay, Burhan
Erdem, Ergün
Erbis, H.
Özden, Akın
Keywords: Adhesion
Adverse effects
Cholecystectomy
Hyaluronic acid
Laparoscopy
hyaluronic acid derivative
abdominal surgery
abscess
adhesion
animal experiment
animal model
article
bile leakage
cholecystectomy
controlled study
drug effect
experimental model
gallstone
gallstone leakage
intraperitoneal abscess
laparoscopic surgery
laparotomy
nonhuman
postoperative complication
postoperative infection
priority journal
rat
surgical wound
tissue adhesion
treatment outcome
Abdominal Abscess
Adhesions
Animals
Bile
Biocompatible Materials
Biomechanics
Escherichia coli Infections
Gallstones
Humans
Hyaluronic Acid
Infusions, Parenteral
Laparotomy
Models, Animal
Rats
Abstract: Background Despite its advantages, iatrogenic gallbladder perforation with resultant spillage of bile and gallstones is not uncommon during laparoscopic cholecystectomy. Although this is not generally considered a significant problem, spilled gallstones may cause problems even years after the operation. Hyaluronic acid has been introduced into clinical practice and successfully used to decrease postoperative adhesions after abdominopelvic surgery. In this study, we investigated the effectiveness of a hyaluronic-acid derivative in preventing complications related to spilled gallstones and bile leakage in an experimental study. Methods In 60 Wistar-Albino rats, an upper-midline abdominal incision was made, and the rats were divided into 5 groups (n = 12 in each group) as follows: group I = laparotomy alone; group II = laparotomy and intraperitoneal instillation of sterile bile plus gallstones; group III = laparotomy and instillation of infected bile and gallstones; group IV = laparotomy and instillation of sterile bile and gallstones plus hyaluronic acid; and group V = laparotomy and instillation of infected bile and gallstones plus HA. A second-look laparotomy was performed on postoperative day 10 to assess intraperitoneal adhesions and abscesses. Intraperitoneal adhesions were scored, and breaking strengths of gallstones were measured. Results Adhesion scores were significantly higher in groups II and III compared with groups I, IV, and V (P <0.05). There was a statistically significant decrease in breaking strengths and adhesion scores in groups IV and V compared with groups II and III (P <0.001). Conclusions Whether infected or not, spilled gallstones and bile caused postoperative adhesions in this experimental model. An HA derivative significantly prevented postoperative adhesions and decreased breaking strengths. Further clinical studies are needed to validate these findings. © 2004 Excerpta Medica, Inc. All rights reserved.
URI: https://hdl.handle.net/11499/5050
https://doi.org/10.1016/j.amjsurg.2004.06.006
ISSN: 0002-9610
Appears in Collections:PubMed İndeksli Yayınlar Koleksiyonu / PubMed Indexed Publications Collection
Scopus İndeksli Yayınlar Koleksiyonu / Scopus Indexed Publications Collection
Tıp Fakültesi Koleksiyonu
WoS İndeksli Yayınlar Koleksiyonu / WoS Indexed Publications Collection

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