| Objective: Up to now the cholecystectomy is still the main curing method for the gall bladder pathological changes. Recent years, the improvement of medical equipment along with diagnoses technology is raised, as well as laparoscopic cholecystectomy made a great satisfactory in the area of Minimally Invasive Surgery there has been a large increase in annual cholecystectomy rates in our country ,and letting even more patients gain curing on foundation. however,there are many pathophysiology changes after cholecystectomy. Stool habit and stool trait changed in some people after cholecystectomy.Even patients have persistence of one or two symptoms such as epigastrium abdominal pain, abdominal distension, diarrhoea and nauseates and detests greasy etc, is called " Postcholecystectolmy Syndrome ( PCS ) ", which make patients unconvenient in life and work. diarrhoea is the most common symptom, have different duration, serious symptom like abdominal pain and critical diarrhoea seldom appear. Stool have great different trait amang different patients. Antibiotic can not help them recovering. the research about its cause seldom reports home and abroad. Therefore patient's diarrhoea question after cholecystectomy must pay more attention to . The intention of this trial is tring to finding out whether or not influencing the intestines movement , By way of tests Intestinal permeability and morphology to observate the intestinal mucosa normal or not. According the result,we can analysis the reason of diarrhoea,and find ways to prophylaxis and treat it.Methods: 40 clean healthy suckling pig, weigh 250-300g,ramdomly divided into 2 groups: normal control group(A), cholecystectomy group(B), with 20 suckling pigs in each group. The animals in groupA were performed sham operation, The animals in groupB give operations of cholecystectomy. All of the operations are sterile. Three weeks later, When models'nick complete heal and diet complete normal , underwent second operation again. fast 12h,drink freely before anesthetize , anesthetize through abdominal cavity. collecting portal vein biood 2ml to measure The level of endotoxin in portal vein.Opens anmials abdominal , pures Barium Sulfate emulsion into cavity 5cm ahead of pylorus and cecum's root. Then,puts the bowel back and closes down the abdominal cavity.30 minutes later,makes animals death,cuts out the stomach and bowel. takes the full intestines hanging down with 5 gs' scales weights.Pylorus and ileocecal valve are the two starting points,measures migration length of each group in small intestine and colon.Gets the whole length of small intestine(from pylorus to ileocecal valve) and colon(from ileocecal valve to anus). Calculates the migration percentage(distence Barium Sulfate moved/ the whole length of small intestine or colon) of each group. Jejunum,ileum and colon tissues were taken for pathologic examination by optical microscopy or electron miscropy, including comparing mucosal thickness, villus height and width and morphology changes of jejunum,ileum and colon.The experimental date was demonstrated in x±s standard deviation. The analysis of variance and t test were used to the significance test and the relation about the date was measured with linear correlation by SPSS10.0,statistic software.Result:1. Compared the migration percentage of small intestine: group A (40.41±3.26%), groupB (56.91±3.24%), the value in group A and group B different (P<0.05).2. Compared the migration percentage of colon: group A (6.64±4.5%), groupB (9.26±3.26%), the value in group A and group B different (P<0.05).3. The content of endotoxin in portal vein blood of each group: group A(0.0391±0.0032EU/ml) and group B(0.0654±0.0331 EU/ml),the value in group A and group B different (P<0.01).4. there was shrink of epithelial under optical microscopic in group B,group A has normal intestine mucous membrane.4.1. The value of jejunum mucosal thickness in each group: It was significantly thicker in group A (364.28±68.40μm) than group B (338.24±51.53μm) (P<0.01).4.2 The value of jejunum villus height in each group:It was significantly wider in group A (288.33±54.23μm) than group B(279.38±42.34μm) (P<0.01).4.3 The value of jejunum villus width in each group: It was significantly higher in group A(72.81±15.04μm) than that in group B(64.28±12.13μm) (P<0.01).4.4 The value of ileum mucosal thickness in each group: It was significantly thicker in group A (288.86±72.00μm) than group B (276.22±27.32μm) (P<0.01).4.5 The value of ileum villus height in each group:It was significantly wider in group A (247.73±65.08μm) than group B(232.19±24.26μm) (P<0.01).4.6 The value of ileum villus width in each group: It was significantly higher in group A(74.19±10.84μm) than that in group B(72.08±18.36μm) (P<0.01).4.7 The value of colon mucosal thickness in each group:It was significantly thicker in group A(454.89±37.63μm) than group B(448.67±61.96μm) (P<0.01).5. observed under electronic microscopes : there was no pathological changes in groupA。In groupB the intestinal epithelial microvilli were rare and deranged; mitochondrial crista was disappeared partly or mostly , mitochondrial membrane damaged , some mitochondrions have cavity.Conclusion: After cholecystectomy, small intestine or colon peristalsis function were strengthened, gut barrier has been damaged, The intestines mucous membrane shrink, and epithelium microvillus reduces, influences the intestines absorbing function.All of these can be the cause of diarrhoea after cholecystectomy. |
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