Studies on Non-bacterial Cholecystitis. A Non-Traumatizing Technique for Study of Chemical Cholecystitis. ∗

Abstract

To produce an experimental cholecystitis from which conclusions can be drawn concerning human cholecystitis, 3 basic postulates must be fulfilled. First, the cholecystitis must be a direct result of the material used, and not even partially due to an inherent defect in the technique. Second, the material introduced must be such as is normally found either in the body fluids or in the ingested food, and should not be artificial and foreign to the body. Third, the reaction produced in the gall-bladder by this material must be similar in appearance to human cholecystitis.

The ideal method for introducing any substances into the gall bladder is by way of its natural passages, e. g., the common duct. This is possible by leading a catheter up into the gall bladder through an opening in the common duct as close to the duodenum as possible, to avoid any manipulation of the gall bladder. To reestablish a rather normal flow of bile, a glass cannula can be fixed in place in the common duct at the point of the opening.

The detailed technique is as follows: The experiments were performed on dogs under ether anesthesia. The abdomen is opened by a midline incision, and the duodenum lifted aside, exposing the common duct. The latter is freed from the surrounding tissue and an untied ligature put around the distal end. An unfolded sponge is inserted under the duct, thus isolating it from all surrounding structures and preventing any bile from flowing on to the peritoneum through the opening which is made. A longitudinal incision about 1 cm. long is now made in the common duct about 1.5 cm. from its entrance into the duodenum, the margins of this opening then being clamped on each side by a moskito forceps. A soft, French rubber catheter, 2.5 to 3.5 mm. in diameter, depending on the width of the duct, is introduced through this opening into the gall bladder. As much bile as possible is then aspirated by means of a syringe attached to the end of the catheter, and an equal amount of material is injected.