Effect Of Gauze Piece Scrub On T-tube Sinus Formation In A Simulated Laparoscopic Rabbit Model

AIM To evaluate the effect of gauze piece scrub on rabbit T-tube sinus formation using an established rabbit model of laparoscopic T tube.MEHTODS72male rabbits were randomly divided into control, laparoscopy, and laparoscopic gauze piece scrub groups (n=24).8rabbits in each group were sacrified at random and assessed at3,7and14days, respectively, after molding. 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 microscopically after dissection to assess intestinal adhesion and fistula formation. In addition, immunohistochemistry was used to quantify matrix metalloproteinase-1(MMP-1) and matrix metalloproteinase-1inhibitors (TIMP-1) in intestinal canal tissues.RESULTS Plasma TGF-β1, IL-6and Fib amounts peaked3days after operation and gradually decreased by time (6.21±0.68、9.17±2.32、9.78±2.75), and reached normal level at14days 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), levels significantly higher than in control serum (P<0.01). MMP-1and TIMP-1activities in the gauze piece scrub group were significantly higher than in laparoscopy and control groups (37.417±5.26、67.41±5.18vs32.46±8.76.52.46±6.81, P<0.05). Finally, the ratio of intestinal adhesion and fistula formation were significantly higher in the gauze piece scrub group compar with the laparoscopy group (P<0.05).CONCLUSION Gauze piece scrub induces inflammatory factor release, increases plasma fibrinogen levels, and enhances the activity of matrix metallo proteinase-1inhibitors, thus promoting the formation of abdominal adhesion and T tube fistula. These findings provide a basis for a convenient, simple, feasible and efficacious method through laparoscopic bile duct exploration of T tube fistula to shorten the time with T tube after operation.