Abstract
Objective To assess the effect of gauze piece scrub on rabbit T-tube sinus formation using an established rabbit model of laparoscopic T tube.Methods Seventy-two male rabbits were randomly divided into sham,laparoscopy,and laparoscopic gauze piece scrub groups (n =24),and assessed at 3rd,7th and 14th day respectively after molding.Enzyme linked immunosorbent assay (ELISA) was used to determine the plasma contents of transforming growth factor-β1 (TGF-β1),interleukin-6 (IL-6) and fibrinogen (Fib).Rabbits were examined macroscopically after dissection to assess intestinal adhesion and fistula formation.In addition,immunohistochemistry was used to quantify matrix metalloproteinase-1 (MMP-1) and matrix metalloproteinase-1 inhibitors (TIMP-1) in intestinal canal tissues.Results Plasma TGF-β1,IL-6 and Fib contents peaked 3 days after operation before gradually decreasing with time (6.21 ± 0.68,9.17 ± 2.32,9.78 ± 2.75),and reached normal levels at 14th day post-operation (4.07 ± 1.57,7.67 ±2.42,8.01 ± 1.92).However,similar protein amounts were found in laparoscopy and gauze piece scrub groups (P＞0.05),and significantly higher than in controls (P＜0.01).MMP-1 and TIMP-1 activities in the gauze piece scrub group were significantly higher than in laparoscopy and sham groups (37.42 ± 5.26,67.41 ±5.18 vs.32.46 ± 8.76,52.46 ± 6.81,P ＜ 0.05).Finally,intestinal adhesion and fistula formation were significantly increased in the gauze piece scrub group as compared with the laparoscopy group (P ＜ 0.05).Conclusion Gauze piece scrub induces inflammatory factor release,increases plasma fibrinogen levels,and enhances the activity of TIMP-1,thus promoting the formation of abdominal adhesions and T tube fistula.These findings provide a basis for a convenient,simple,feasible and efficacious method toward laparoscopic bile duct exploration of T tube fistula to shorten the time with T tube after operation. Key words: T-tube sinus; Bile duct exploration; Rabbit
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