Pelvic adhesion formation after intraperitoneal installation of gallstones in a rabbit model

Objective: To investigate whether intraperitoneal gallstones increase the risk 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 human serum albumin and bile group (antigenic control). Three weeks after the operation individual subjects were randomized, with groups concealed to observers, 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 gallstone 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 increase the morbidity of laparoscopic cholecystectomy. In females of reproductive age these gallstones may induce pelvic adhesions that may interfere with fertility or be associated with pelvic pain.