internal gallbladder drainage prevents development of acute cholecystitis in a pig model a randomized study内部急性胆囊炎胆囊引流阻碍发展的一头猪模型随机研究.pdfVIP

Kjaer et al. Annals of Surgical Innovation and Research 2010, 4:4 /content/4/1/4 R E S E A R C H A R T I C L E Open Access Research article Internal gallbladder drainage prevents development of acute cholecystitis in a pig model: a randomized study 1 1 2 3 1 Daniel W Kjaer* , Frank V Mortensen , Jens K Møller , Stephen J Hamilton-Dutoit and Peter Funch-Jensen 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 drai