Pelvic adhesion formation after intraperitoneal installation of gallstonesin a rabbit model

Objective: To investigate whether intraperitoneal gallstones increase the r isk of pelvic adhesions in a rabbit model. Design: Prospective, randomized, blinded, sham and human antigen controlled trial. Setting: An academic research environment. Subject(s): Twelve New Zealand white rabbits. Intervention(s): Twelve rabbits were divided into three groups of four each ; a sham operation group, a gallstone and bile group (study group), and a h uman serum albumin and bile group (antigenic control). Three weeks after th e operation individual subjects were randomized, with groups concealed to o bservers, and a necropsy was performed on each rabbit. Main Outcome Measurement(s): Necropsy was performed on each rabbit, and the adhesions were scored for extent, type, tenacity, inflammation, and gallst one involvement. Result(s): There was a statistically and biologically significant increase in gallstone involvement in adhesions, especially pelvic adhesions, in the study group. Conclusion(s): This study, along with an increasing number of case reports, suggests that gallstones inadvertently left in the peritoneal cavity may i ncrease the morbidity of laparoscopic cholecystectomy. In females of reprod uctive age these gallstones may induce pelvic adhesions that may interfere with fertility or be associated with pelvic pain. (Fertil Sterile(R) 1999;7 2:868-72 (C) 1999 by American Society for Reproductive Medicine.).