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Colecistite Aguda. Aspectos Clínicos e Experimentais
difficulties found, it is imperative to resort to laparotomy as a sign of surgical
maturity and good sense.
Due to the fact that some authors were duly impressed with the decrease
of painful symptomatology during biliary colic by cholelithiasis after the
administration of non-steroid anti-inflammatory, the hypothesis was
considered that those drugs could cause a favourable effect in the evolution
of acute cholecystitis. This aspect, if confirmed, would have interest in making
the regression of gallbladder lesions possible, considerably facilitating
laparoscopic surgery.
In order to investigate this, we resorted to the experimental animal. Our
first objective was to obtain a model of acute cholecystitis. So we used the
rabbit first and later the pig. The ligature of the cystic duct and the cystic artery
did not reproduce lesions of acute cholecystitis. This was achieved by
associating to that technique the gallbladder introduction of
lysophosphatidilcoline.
We thus obtained gallbladder lesions which we classified as not severe
(edema, plastic reaction of the serosa,discrete infiltrated inflammatory) and
severe (intense infiltrated inflammatory and necrosis).
In the rabbit group (C2) in which that technique was used we obtained
91.6% severe lesions and 8.3% discrete lesions.
To the mortality in the rabbit (7 in 35 experiments) we later
experimented on the pig, also because of the greater technical facility provided
by the size of the pigs.
We used 40 pigs in a total of 43 animals (3 died in the per-operative)
divided in 2 groups: P1 (17 pigs) and P2 (23 pigs) associating in this last group
the administration of Diclofenac (Voltaren).
In group P1 we obtained severe lesions in 82.3% and discrete in 17.6%.
In group P2, 82.6% severe lesions were registered and 17.3% discrete; there
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