Study On Changes Of IL-18 And Endotoxin In Gallbladder Tissues ,Endotoxin In Serum And Gallbladder Pathology When Obstruction Of Common Bile Duct Causes The Acute Cholecystitis And Relieves The Common Bile Duct Obstruction

Objective: The acute cholecystitis caused by obstruction of common bile duct is a common clinical disease,but there are few reports about the acute cholecystitis caused by obstruction of common bile duct,there are few animal studies about the changes of Interleukin-18 ,endotoxin in gallbladder tissues ,endotoxin in serum and gallbladder pathology when obstruction of common bile duct causes the acute cholecystitis in china. Our study developed the animal model of acute common bile duct (CBD) obstruction,changes of Interleukin-18 ,endotoxin in gallbladder tissues ,endotoxin in serum and gallbladder pathology are observed for providing animal experiments and theoretic supports for clinical treatment of acute cholecystitis caused by common bile duct (CBD) obstruction.Methods: 54 healthy rabbits, weighing 2.2-2.5kg,in half respectively male and female, were randomly divided into nine groups, six in one group: normal control group (N); common bile duct obstruction group (L), in which group L1 for obstruction one day, group L3 for obstruction three days, group L5 for obstruction five days, group L7 for obstruction seven days; obstruction relief group (R), in which group R1 for relief after one day, group R3 for relief after three days, group R5 for relief after five days, group R7 for relief after seven days .Before operation, each rabbit is provided water, no food. developed the animal model succeedly . For the rabbits in group B, put them into death after obstruction for 1 day, 3days, 5days and 7 days respectively; for group R, put them into death 72 hours after obstruction relief. 5 milliliter blood is drawn from heart of all rabbits and serum is separated, 2500r/min,used Endpoint Chromogenic TAL to detect endotoxin in serum and gallbladder tissue. The method of ELISA was used to measure IL-18 in gallbladder tissue.The gallbladder pathologic changes were observed with microscope after HE staining. The experimental data were expressed as mean±standard deviation.The experimental data were analyzed by SPSS 13.0,a statistic sofeware.The comparion of the means uesd one–way ANOVA and Student-Newman-Keuls,if P<0.05, the difference is taked as to have statistic significance.Results: General conditions and pathology of the gallbladder: earlier period of common bile duct obstruction, Compared with group N, the gallbladder volume of rabbits in group L1 and L3 becomes larger and the gallbladder wall becomes thicker and edema, while the gallbladder wall is integrated and has no ulcer, the bile is in deep yellow; under the microscope: membrane epidermis integrated,each layer has edema, the blood vessels are congested and a few inflammatory cell soaks. Along with the obstruction time prolong, gallbladder inflammatory aggravates.The inflammatory of L5 group is serious,the gallbladder volume of rabbits has a significant dilation, the bile is thickness and dark green mostly,membrane desquamates partly, forming small ulceration. And gall-stone can be founded.under the microscope: membrane epidermis desquamates partly, blood vessel dilates seriously,. Each layer has a large number of inflammatory cells soaked . The gallbladder tissue of L7 group becomes black,the gallbladder wall of L7 group becomes weaker, membrane plica disappear,under the microscope: membrane epidermis disappear, a plenty of white blood cell oddments, each layer slur, when inflammatory become severity, gallbladder may mortification or perforation. Inflammation is decreased in group R compared with group L in the same period.The content of IL-18 , endotoxin in gallbladder tissue and serum endotoxin gradually goes up with the time prolong, there has statistic significance among the group of L1, L3, L5 and L7 (P<0.05); the content of IL-18 , endotoxin in gallbladder tissue and serum endotoxin decreases in group R compared with group L in the same period, having statistic significance (P<0.05).The earlier we relieves the common bile duct obstruction,The lower of the content of IL-18 , endotoxin in gallbladder tissue and serum endotoxin is,The lighter of the inflammation in gallbladder tissue is.Conclusions:1 Common bile duct obstruction can cause acute cholecystitis. Gallbladder inflammation is increased gradually with the increasing of obstruction time. After obstruction relief, gallbladder tissue inflammation decreases. The earlier we relieves the common bile duct obstruction,The lighter the inflammation of gallbladder tissue is.2 After common bile duct obstruction ,increasing of obstruction time, the content of IL-18 in gallbladder tissue of the group CBD increases gradually,After obstruction relief, the content of IL-18 in gallbladder tissue decreases. This indicate that IL-18 as a proinflammatory ctyokine plays a role in the cholecystitis causes by common bile duct obstruction,furthermore,It is possible that IL-18 is an index indicating the degree of cholecystitis.3 After common bile duct obstruction ,increasing of obstruction time, the content of endotoxin in gallbladder tissue and in serun of the group CBD increases gradually,After obstruction relief, the content of endotoxin decreases. Endotoxin plays an important part in inflammation of gallbladder tissue and systemic inflammatory response.