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Laparoscopic Common Bile Duct Exploration in Patients with a Previous History of Biliary Tract Surgery

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Perihepatic adhesions: another look.

A Chatwani¹, N Mohammed, S Amin-Hanjani

¹Department of Obstetrics and Gynecology 7 OPD Temple University Hospital 3401 N. Broad Street, Philadelphia, PA 19140, USA.

Infectious Diseases in Obstetrics and Gynecology

|January 1, 1995

Summary

Pelvic inflammatory disease (PID) may not be the sole cause of perihepatic adhesions. This study found adhesions in patients without prior PID, suggesting other factors contribute to their formation.

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Area of Science:

Gynecology
Infectious Diseases
Surgical Pathology

Background:

Perihepatic adhesions are often associated with pelvic inflammatory disease (PID).
The specific etiology of perihepatic adhesions in the absence of documented PID requires further investigation.

Purpose of the Study:

To investigate whether pelvic inflammatory disease (PID) is the exclusive cause of perihepatic adhesions.
To identify potential alternative causes of perihepatic adhesions.

Main Methods:

Laparoscopic evaluation of 100 patients undergoing elective sterilization.
Preoperative workup including cultures, blood tests, and physical examination.
Intraoperative collection of cultures and tissue samples from adhesions and pelvic organs in cases of unexplained perihepatic adhesions.

Main Results:

Seven out of 100 patients presented with perihepatic adhesions without laparoscopic evidence of prior PID.
Preoperative cultures and anti-chlamydial antibody titers were negative in these patients.
Histological examination revealed chronic salpingitis in two patients with adhesions and a history suggestive of prior infection.

Conclusions:

Pelvic inflammatory disease (PID) may not be the only factor leading to the development of perihepatic adhesions.
The findings suggest that other etiological factors should be considered in patients with perihepatic adhesions.