The effects of preoperative milk drinking on gallbladder perforation during laparoscopic cholecystectomy

  • Mohammad Moazeni- Bistgani Department of Surgery, Shahrekord University of Medical Sciences, Shahrekord, Islamic Republic of Iran
Keywords: Cholecystectomy, laparoscopic, gallbladder diseases, iatrogenic gallbladder perforation, gallbladder distention

Abstract

One of the complications of laparoscopic cholecystectomy (LC) is gallbladder perforation during surgery. Fasting before surgery causes gallbladder distention, which may increase the chance of iatrogenic gallbladder perforation during LC. A fatty meal stimulates endogenous cholecystokinin release and, consequently, the gallbladder contraction. This study evaluates the effects of preoperative milk drinking on gallbladder distention and iatrogenic gallbladder perforation during LC. This study was performed on patients who were candidates for elective LC in a university hospital from March 2011 to March 2012. 260 patients were randomly divided into two equal groups. The case group drank 300 mL of cold full-fat pasteurized cow’s milk, while the control group drank 300 mL of cold water as the placebo, six hours before LC surgery. Data were collected in a questionnaire and analyzed using descriptive statistical tests, t-test, and ANOVA analysis. In the 260 patients, despite a lack of significant differences in demographic and risk factors for gallbladder perforation between the two groups, both distention and gallbladder perforation rates were significantly lower in the case group than in the control group (P = 0.001 and, P = 0.032, respectively). Thus, drinking cold full-fat pasteurized cow’s milk before LC surgery can reduce gallbladder distention and, consequently, the risk of gallbladder perforation during LC.

References

Calik A, Topaloglu S, Topcu S, Turkyilmaz S, Kucuktulu U, et al. Routine intraoperative aspiration of gallbladder during laparoscopic cholecystectomy. Surg Endosc 2007; 21(9): 1578–1581. doi: 10.1007/s00464-006-9159-7.

Hui TT, Giurgiu DI, Margulies DR, Takagi S, Iida A, et al. Iatrogenic gallbladder perforation during laparoscopic cholecystectomy: Etiology and sequelae. Am Surg 1999; 65(10): 944–948.

Krishnamurthy GT, Bobba VR, Kingston E. Radionuclide ejection fraction: A technique for quantita-tive analysis of motor function of the human gallbladder. Gas¬troenterology 1981; 80(3): 482–490.

Nora PF, Davis RP, Fernandez MJ. Chronic acalculous gallbladder disease: A clinical enigma. World J Surg 1984; 8(1): 106–112. doi: 10.1007/BF01658378.

Pomeranz IS, Shaffer EA. Abnormal gallbladder emptying in a subgroup of patients with gallstones. Gas-troenterology 1985; 88(3): 787–791.

Krishnamurthy GT, Bobba VR, McConnell D, Turner F, Mesgarzadeh M, et al. Quantitative biliary dynamics: Introduction of a new noninvasive scintigraphic technique. J Nucl Med 1983; 24(3): 217–223.

Mackie CR, Baxter JN, Grime JS, Hulks G, Cuschieri A. Gall bladder emptying in normal subjects—A data base for clinical cholescintigraphy. Gut 1987; 28(2): 137–141. doi: 10.1136/gut.28.2.137.

Bricault I. Infections of the right hypochondrium. Diagn Interv Imaging 2012; 93(6): 453–465.

doi: 10.1016/j.diii.2012.04.005.

Zulfikaroglu B, Ozalp N, Mahir Ozmen M, Koc M. What happens to the lost gallstone during laparoscopic cholecystectomy? Surg Endosc 2003; 17(1): 158.

Zubair M, Habib L, Mirza MR, Channa MA, Yousuf M. Iatrogenic gall bladder perforations in laparoscopic cholecystectomy: An audit of 200 cases. Mymensingh Med J 2010; 19(3): 422–426.

Pallotta N. Ultrasonography in the assessment of gall¬bladder motor activity. Dig Liver Dis 2003; 35(Suppl 3): S67–S69. doi: 10.1016/S1590-8658(03)00098-7.

Krishnamurthy GT, Bobba VR, Kingston E. Optimization of octapeptide of cholecystokinin (OP-CCK) dose for gallbladder emptying. In: Raynaud C (editor). Proceeding of the 3rd World Congress of Nuclear Medi-cine and Biology. Paris: Pergamon Press; 1982. p. 2244–2247.

Caliskan K, Nursal TZ, Yildirim S, Moray G, Torer N, et al. Hydrodissection with adrenaline-lidocaine-saline solution in laparoscopic cholecystectomy. Langenbecks Arch Surg 2006; 391(4): 359–363. doi: 10.1007/s00423-006-0049-1.

American Society of Anesthesiologists Committee on Standards and Practice Parameters. Practice guidelines for preoperative fasting and the use of pharmacologic agents to reduce the risk of pulmonary aspiration: Application to healthy patients undergoing elective procedures: A report by the American Society of Anes¬thesi¬ologist Task Force on Preoperative Fasting. Anesthe¬siology 1999; 90(3): 896–905.

Bobba VR, Krishnamurthy GT, Kingston E, Turner FE, Brown PH, et al. Gallbladder dynamics induced by a fatty meal in normal subjects and patients with gallstones: Concise communication. J Nucl Med 1984; 25(1): 21–24.

Thompson JC, Fender HR, Ramus NI, Villar HV, Rayford PL. Cholecystokinin metabolism in man and dogs. Ann Surg 1975; 182(4): 496–504. doi: 10.1097/00000658-197510000-00015.

Jonderko K, Nowak A, Kasicka-Jonderko A, Błasz-czyńska M. Effect of cigarette smoking on gallbladder emptying and filling in man. Am J Gastroenterol 1994; 89(1): 67–71.

Davis NS. Milk and milk products. Part 3. Milk di-gestion. 2nd ed. In: Food in health and disease [Internet]. Philadelphia, USA: P. Blakiston’s Son & Co.; 1912 [cited 2016 Jun 14]. Available from: http://chestofbooks. com/health/nutrition/Disease-Food/Milk-And-Milk-Products-Part-3-Milk-Digestion.html

Aytaç B, Çakar S. The outcome of gallbladder perforation during laparoscopic cholecystectomy. Acta Chir Belg 2003; 103(4): 388–391. doi: 10.1080/00015458.2003.11679449.

Published
2020-10-27
Section
Clinical Trial