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Artigos Originais • Rev. Col. Bras. Cir. 26 (4) • Ago 1999 • https://doi.org/10.1590/S0100-69911999000400003   copiar

Reação peritoneal tardia ao calculo biliar humano, de colesterol, deixado na cavidade abdominal de ratos

Late peritoneal reaction to human cholesterol gallstone left into abdominal cavity of rats

Autoria SCIMAGO INSTITUTIONS RANKINGS

Resumos

Foram avaliados os resultados tardios da colocação de cálculos biliares humanos, de colesterol, na cavidade peritoneal de ratos. Constituíram-se cinco grupos: cinco ratos foram apenas laparotomizados com manuseio da cavidade; cinco foram laparotomizados e receberam um ponto com fio monofilamentar cinco zeros no sulco paracólico direito e mesentério; dez receberam cálculos que foram deixados livres na cavidade peritoneal; em dez, os clculos foram fixados no sulco paracólico direito e, finalmente, dez tiveram clculos fixados no mesentério. Os animais foram mortos após cinco meses de pós-operatório quando se observou a cavidade abdominal e foi coletado material para estudo histopatológico. Concluiu-se que os cálculos não foram absorvidos, desenvolveram uma reação peritoneal do tipo corpo estranho com formação de plastrão e foram envolvidos por tecido fibroso e células inflamatórias.

Colecistectomia laparoscópica; Colelitíase; Peritônio; Reação a corpo estranho; Ratos

It was evaluated the late results of human gallstones placed into peritoneal cavity of rats. Five groups were created. In the first (group A) five rats were submitted only to laparotomy and handling of abdominal cavity, in the second (group B) five rats were submitted to laparotomy and a stitch was placed into right abdominal wall and in mesenterium between the ileus and cecum, in the third (group C) ten rats received a gallstone left free into abdomen, in the fourth (group D) ten rats received a gallstone fixed into right abdominal wall and in the fifth (group E) ten rats received a gallstone fixed in mesenterium between the ileus and cecum. One rat in each group was selected to be use as a pilot and were re-laparotomized after 1 month and 3 months, in order to look for any possible alteration. All rats were dead after five months when the abdominal cavity was observed and specimens were collected around the gallstones to histopathology. ln groups A and B there were not important macroscopic alterations. The gallstones were not absorved in groups C, D and E and were involved in a transparent tissue or blocked by omentum and intestinal loops. The rat used as a pilot in group E had a sub- intestinal occlusion and the gallstone was not found after 5 months. We supposed that it migrated to into the bowel. Histopathology did not showed any alteration in groups A and B but showed fibrosis. inflamatory cells, hemossiderin, calcifications and a foreign body like reaction in groups C, D and E (except the pilot rat). It was concluded that gallstones were not absorbed and a foreign body like reaction appeared. The gallstones were involved with fibrosis and inflamatory cells.

Laparoscopic cholecystectomy; Gallstones; Peritoneum; Foreign body reaction; Rats

ARTIGOS ORIGINAIS

Reação peritoneal tardia ao calculo biliar humano, de colesterol, deixado na cavidade abdominal de ratos

Late peritoneal reaction to human cholesterol gallstone left into abdominal cavity of rats

Luiz Carlos BertgesI; Alcino Lázaro da Silva, TCBC-MGII; Ronaldo Rocha BastosIII; Ângela Marial GollnerIV; Vera Maria PetersV; Walkyria Dutra Dias Araújo LessaVI

IProfessor Adjunto do Departamento de Fisiologia - ICB - UFJF

IIProfessor Titular de Cirurgia do Aparelho Digestivo - UFMG

IIIProfessor Adjunto do Departamento de Estatística - ICE - UFJF

IVProfessora Adjunta do Departamento de Patologia da Faculdade de Medicina da UFJF

VProfessora Adjunta e Chefe do Centro de Biologia da Reprodução da UFJF

VIProfessora Adjunta do Departamento de Bioquímica - ICB - UFJF

Endereço para correspondência Endereço para correspondência: Dr. Luiz Carlos Bertges Rua Benjamin Colucci 50/3 - Centro 36 010-600 - Juiz de Fora - MG E mail: bertges@jfa.nutecnet.com.br

RESUMO

Foram avaliados os resultados tardios da colocação de cálculos biliares humanos, de colesterol, na cavidade peritoneal de ratos. Constituíram-se cinco grupos: cinco ratos foram apenas laparotomizados com manuseio da cavidade; cinco foram laparotomizados e receberam um ponto com fio monofilamentar cinco zeros no sulco paracólico direito e mesentério; dez receberam cálculos que foram deixados livres na cavidade peritoneal; em dez, os clculos foram fixados no sulco paracólico direito e, finalmente, dez tiveram clculos fixados no mesentério. Os animais foram mortos após cinco meses de pós-operatório quando se observou a cavidade abdominal e foi coletado material para estudo histopatológico. Concluiu-se que os cálculos não foram absorvidos, desenvolveram uma reação peritoneal do tipo corpo estranho com formação de plastrão e foram envolvidos por tecido fibroso e células inflamatórias.

Unitermos: Colecistectomia laparoscópica; Colelitíase/complicações; Peritônio; Reação a corpo estranho; Ratos.

ABSTRACT

It was evaluated the late results of human gallstones placed into peritoneal cavity of rats. Five groups were created. In the first (group A) five rats were submitted only to laparotomy and handling of abdominal cavity, in the second (group B) five rats were submitted to laparotomy and a stitch was placed into right abdominal wall and in mesenterium between the ileus and cecum, in the third (group C) ten rats received a gallstone left free into abdomen, in the fourth (group D) ten rats received a gallstone fixed into right abdominal wall and in the fifth (group E) ten rats received a gallstone fixed in mesenterium between the ileus and cecum. One rat in each group was selected to be use as a pilot and were re-laparotomized after 1 month and 3 months, in order to look for any possible alteration. All rats were dead after five months when the abdominal cavity was observed and specimens were collected around the gallstones to histopathology. ln groups A and B there were not important macroscopic alterations. The gallstones were not absorved in groups C, D and E and were involved in a transparent tissue or blocked by omentum and intestinal loops. The rat used as a pilot in group E had a sub- intestinal occlusion and the gallstone was not found after 5 months. We supposed that it migrated to into the bowel. Histopathology did not showed any alteration in groups A and B but showed fibrosis. inflamatory cells, hemossiderin, calcifications and a foreign body like reaction in groups C, D and E (except the pilot rat). It was concluded that gallstones were not absorbed and a foreign body like reaction appeared. The gallstones were involved with fibrosis and inflamatory cells.

Key words: Laparoscopic cholecystectomy; Gallstones/Complications; Peritoneum; Foreign body reaction; Rats.

Texto completo disponível apenas em PDF.

Full text available only in PDF format.

REFERÊNCIAS

1. Dani R, Portela FN, Nogueira CE. "Litíase biliar". In Dani R, Paula Castro L: Gastroenterologia Clínica. 3a Edição, Rio de Janeiro: Guanabara Koogan, 1993, pp 1515-1540.

2. McSherry CK. Advantages of elective surgical treatment of gallstones. Hepatogastroenterol 1989;36:330-332.

3. Dubois F, Berthelot G, Levard H. Cholécystectomie sous coelioscopie. Ann Chir 1990;44(3):203-206.

4. Evrard S, Miranda E, Marescaux J. Cholécystectomie par coeliovidéoscopie. Encyclopédie Médico-Chirurgicale (Paris). 1992; 7.047 G 15.

5. Walshaw CF, Deans H, Krukowski ZH. Free intraperitoneal gallstones following laparoscopic cholecystectomy. Clin Radiol 1993; 48:258-259.

6. Fielding GA. Laparoscopic cholecystectomy. Australian and New Zealand Journal of Surgery 1992;62:181-187.

7. Williams PR, Foster ME, Lewis MH. Late discharge of stones after laparoscopic cholecystectomy. Br J Surg 1994;81 :152.

8. Leland DG, Dawson DL. Adhesions and experimental intraperitoneal gallstones. Contemp Surg 1993;42:273-276.

9. Welch N, Hinder RA, Fitzgibbons RJ, et al. Gallstones in the peritoneal cavity. A clinical and experimental study. Surg Laparosc Endosc 1991;1(4):246-247.

10. Kent RB, Stahl RD. Laparoscopic retrieval of spilled stones. Surg Laparosc Endosc 1992;2(2):152-153.

11. Johnston S, Q'Malley K, Mc Entee G, et al. The need to retrieve the dropped stone during laparoscopic cholecystectomy. Am J Surg 1994; 167:608-610.

12. Sax HC, Adams JT. The fate of spilled gallstone. Arch Surg 1993; 128 (4):469.

13. Nassif PAN. Estudo experimental das alterações causadas pela bile humana, cálculos biliares humanos e grampos de titânio na cavidade peritoneal de ratos. Tese de mestrado. Curitiba: Ciências da Saúde da UFP. 1995. 48p. ilust.

14. Cline RW, Poulos E, Clifford EJ. An assessment of potential complications caused by intraperitoneal gallstones. Surg Com 1994; 60 (5):303-305.

15. Empinotti CL. Cálculos biliares na cavidade peritoneal: estudo experimental. Tese de mestrado. Curitiba: Ciências da Saúde da UFP. 1995. 30p. ilust.

16. Griffith JQ, Farris EJ. The rat in laboratory investigation. Philadephia. Lippincott Company, Iv., 1942. 488p. ilust.

17. Lee VS, Paulson EK, Libby E, et al. Cholelithoptysis and cholelithorrea: rare complications of laparoscopic cholecystectomy. Gastroenterology 1993; 105:1.877-1.881.

18. Neumeyer DA, Lo Cícero J, Pinkston P. Complex pleural effusion associated with a subphrenic gallstone phlegmon following laparoscopic cholecystectomy. Chest 1996;109 (1):284-286.

19. Thompson J, Pisano E, Warshauer D. Cholelithoptysis: an unusual complication of laparoscopic cholecystectomy. Clin lmag 1995; 19(2):118-121.

20. Chia JKS, Ross M, Calif T. Gallstones exiting the urinary bladder: a complication of laparoscopic cholecystectomy. Arch Surg 1995; 130(6):677.

21. Ponce J, Cutshall KE, Hodge MJ, et al. The lost laparoscopic stone: potential for long-term complications. Arch Surg 1995;130(6): 666-668.

22. Huynh T, Mercer CD. Early postoperative small bowel obstruction caused by spilled gallstones during laparoscopic cholecystectomy. Surgery 1996; 119(3):352-353.

23. Paul A, Eypasch EP, Holthausen U, et al. Bowel obstruction cause by a free intraperitoneal gallstone: a late complication after laparoscopic cholecystectomy. Surgery 1995; 117(5):595-596.

24. Nicolai P, Foley RJE. Complications of spilled gallstones. J Laparosc Surg 1992; 2(6):362-363.

25. Cullis SNR, Jeffery PC, McLauchlan G, et al. Intraperitoneal abscess after laparoscopic cholecystectomy: brief clinical report. Surg Laparosc Endosc 1992;2(4):337-338.

26. Rioux M, Asselin A, Grégoire R, et al. Delayed peritoneal and retroperitoneal abscesses caused by spilled gallstones: a complication following laparoscopic cholecystectomy. Abdom Imag 1995;20 (3):219-221. 27.

27. Bour ES, Gifford RR. Gallstone umbilical sinus tract formation following laparoscopic cholecystectomy. Arch Surg 1995;130(9):1.007-1.008.

28. Guy PR, Watkin OS, Thompson MH. Late discharge of stones after laparoscopic cholecystectomy. Br J Surg 1993;80: 1.052.

29. Gallinaro RN, Miller FB. The lost gallstone: complication after laparoscopic cholecystectomy. Surg Endosc 1994;8(8): 913-914.

30. Soper 111:1, Dunnegan DL. Does intraoperative gallbladder perforation influence the early outcome of laparoscopic cholecystectomy? Surg Laparosc Endosc 1991;1(3):156-161.

Recebido em 3/3/99

Aceito para publicação em 15/7/99

Trabalho dos Departamentos de Cirurgia, da Faculdade de Medicina da UFMG e de Fisiologia do Instituto de Ciências Biológicas da UFJF.

  • 1. Dani R, Portela FN, Nogueira CE. "Litíase biliar". In Dani R, Paula Castro L: Gastroenterologia Clínica. 3a Edição, Rio de Janeiro: Guanabara Koogan, 1993, pp 1515-1540.
  • 2. McSherry CK. Advantages of elective surgical treatment of gallstones. Hepatogastroenterol 1989;36:330-332.
  • 3. Dubois F, Berthelot G, Levard H. Cholécystectomie sous coelioscopie. Ann Chir 1990;44(3):203-206.
  • 4. Evrard S, Miranda E, Marescaux J. Cholécystectomie par coeliovidéoscopie. Encyclopédie Médico-Chirurgicale (Paris). 1992; 7.047 G 15.
  • 5. Walshaw CF, Deans H, Krukowski ZH. Free intraperitoneal gallstones following laparoscopic cholecystectomy. Clin Radiol 1993; 48:258-259.
  • 6. Fielding GA. Laparoscopic cholecystectomy. Australian and New Zealand Journal of Surgery 1992;62:181-187.
  • 7. Williams PR, Foster ME, Lewis MH. Late discharge of stones after laparoscopic cholecystectomy. Br J Surg 1994;81 :152.
  • 8. Leland DG, Dawson DL. Adhesions and experimental intraperitoneal gallstones. Contemp Surg 1993;42:273-276.
  • 9. Welch N, Hinder RA, Fitzgibbons RJ, et al. Gallstones in the peritoneal cavity. A clinical and experimental study. Surg Laparosc Endosc 1991;1(4):246-247.
  • 10. Kent RB, Stahl RD. Laparoscopic retrieval of spilled stones. Surg Laparosc Endosc 1992;2(2):152-153.
  • 11. Johnston S, Q'Malley K, Mc Entee G, et al. The need to retrieve the dropped stone during laparoscopic cholecystectomy. Am J Surg 1994; 167:608-610.
  • 12. Sax HC, Adams JT. The fate of spilled gallstone. Arch Surg 1993; 128 (4):469.
  • 13. Nassif PAN. Estudo experimental das alterações causadas pela bile humana, cálculos biliares humanos e grampos de titânio na cavidade peritoneal de ratos. Tese de mestrado. Curitiba: Cięncias da Saúde da UFP. 1995. 48p. ilust.
  • 14. Cline RW, Poulos E, Clifford EJ. An assessment of potential complications caused by intraperitoneal gallstones. Surg Com 1994; 60 (5):303-305.
  • 15. Empinotti CL. Cálculos biliares na cavidade peritoneal: estudo experimental. Tese de mestrado. Curitiba: Cięncias da Saúde da UFP. 1995. 30p. ilust.
  • 16. Griffith JQ, Farris EJ. The rat in laboratory investigation. Philadephia. Lippincott Company, Iv., 1942. 488p. ilust.
  • 17. Lee VS, Paulson EK, Libby E, et al. Cholelithoptysis and cholelithorrea: rare complications of laparoscopic cholecystectomy. Gastroenterology 1993; 105:1.877-1.881.
  • 18. Neumeyer DA, Lo Cícero J, Pinkston P. Complex pleural effusion associated with a subphrenic gallstone phlegmon following laparoscopic cholecystectomy. Chest 1996;109 (1):284-286.
  • 19. Thompson J, Pisano E, Warshauer D. Cholelithoptysis: an unusual complication of laparoscopic cholecystectomy. Clin lmag 1995; 19(2):118-121.
  • 20. Chia JKS, Ross M, Calif T. Gallstones exiting the urinary bladder: a complication of laparoscopic cholecystectomy. Arch Surg 1995; 130(6):677.
  • 21. Ponce J, Cutshall KE, Hodge MJ, et al. The lost laparoscopic stone: potential for long-term complications. Arch Surg 1995;130(6): 666-668.
  • 22. Huynh T, Mercer CD. Early postoperative small bowel obstruction caused by spilled gallstones during laparoscopic cholecystectomy. Surgery 1996; 119(3):352-353.
  • 23. Paul A, Eypasch EP, Holthausen U, et al. Bowel obstruction cause by a free intraperitoneal gallstone: a late complication after laparoscopic cholecystectomy. Surgery 1995; 117(5):595-596.
  • 24. Nicolai P, Foley RJE. Complications of spilled gallstones. J Laparosc Surg 1992; 2(6):362-363.
  • 25. Cullis SNR, Jeffery PC, McLauchlan G, et al. Intraperitoneal abscess after laparoscopic cholecystectomy: brief clinical report. Surg Laparosc Endosc 1992;2(4):337-338.
  • 26. Rioux M, Asselin A, Grégoire R, et al. Delayed peritoneal and retroperitoneal abscesses caused by spilled gallstones: a complication following laparoscopic cholecystectomy. Abdom Imag 1995;20 (3):219-221. 27.
  • 27. Bour ES, Gifford RR. Gallstone umbilical sinus tract formation following laparoscopic cholecystectomy. Arch Surg 1995;130(9):1.007-1.008.
  • 28. Guy PR, Watkin OS, Thompson MH. Late discharge of stones after laparoscopic cholecystectomy. Br J Surg 1993;80: 1.052.
  • 29. Gallinaro RN, Miller FB. The lost gallstone: complication after laparoscopic cholecystectomy. Surg Endosc 1994;8(8): 913-914.
  • 30. Soper 111:1, Dunnegan DL. Does intraoperative gallbladder perforation influence the early outcome of laparoscopic cholecystectomy? Surg Laparosc Endosc 1991;1(3):156-161.
  • Endereço para correspondência:
    Dr. Luiz Carlos Bertges
    Rua Benjamin Colucci 50/3 - Centro
    36 010-600 - Juiz de Fora - MG
    E mail:

    • Datas de Publicação

    • Publicação nesta coleção
      26 Jan 2010
    • Data do Fascículo
      Ago 1999

    Histórico

    • Aceito
      15 Jul 1999
    • Recebido
      03 Mar 1999
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