Experimental And Clinical Studies On Seromuscular Anastomosesof Gallbladder's Wall In Gallbladder-preserving Cholecystolithotomy

PartⅠExperimental studies on seromuscular anastomoses of gallbladder's wall in rabbitObjectives Explore the feasibility of seromuscular anastomosis of gallbladder's wall in rabbit.Methods The thirty-six rabbits were divided into three groups on randomization ,seromuscular anastomosis group(n=14),whole-layer anastomosis group(n=14)and control group(n=8).Each ribbit was performed process on group in advance ,to observe the abdominal cavity and take the gallbladder in postoperative days 7 and days 21,respectively.The sutured tissue was send to pathological examination.Results⑴After postoperative,all experiment rabbit does not have the bile leakage or the abdominal cavity infects.⑵The pathological section show that the mucosa of suture have recovered in postoperative days 7,the collagen fibers of suture have been crossed and blending in postoperative days 21.⑶Seromuscular anastomosis group and whole-layer anastomosis group after postoperative, the gallbladder wall dropsy situation (P=0.814), inflammation responded(P=0.247),cell proliferation situation (P=0.721) ,and collagen fiber content compared (P=0.475), P values are large at 0.05, does not have statistics significance.⑷Sandy stones formed in the postoperative gallbladders,the formation rate comparison between two groups ,it was not satistically significant (P=0.10,P>0.05).Conclusions⑴The model to suture the gallbladder wall by seromuscular anastomosis and whole-layer anastomosis can be established through thde rabbit.⑵This experiment proved that is feasibility and safety to suture the gallbladder wall by seromuscular anastomosis and whole-layer anastomosis.PartⅡClinical studies on seromuscular anastomoses of gallbladder's wallObjective To determine the feasibility of seromuscular anastomosis of gallbladder's wall in clinical practiceMethods To analyze 31 cases after EGPCL(endoscopic gallbladder-preserving cholecystolithotomy)between January 2011 to April 2011. 11 patients accepted seromuscular anastomoses of gallbladder's wall and 20 patients accepted whole-layer or double layer anastomoses .Results All patients were successful operation, no postoperative biliary fistula, fever and abdominal pain.Conclusion⑴It is feasibility and safety to suture the gallbladder wall by seromuscular anastomosis and whole-layer or double layer anastomosis.⑵The operation of seromuscular anastomosis is more easy than whole-layer or double layer anastomosis and it's incision is more neat.