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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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