Application Of Absorbable Ligating Clips In Cholecystectomy In Rabbits

Objective:To provide an experimental basis for clinical application of the absorbable ligating clip (Huayang) on the hemostatic effect and absorbability as well as liver and renal functional damage after cholecystectomy, and compared its differences with similar imported product (Tyco absorbable ligating clip) and common thread.Methods:(1)76healthy adult New Zealand white rabbits, male/female, were randomly divided into four groups:normal control group (6rabbits), Huayang absorbable ligating clip group (26rabbits)), Tyco absorbable ligating clip group (26rabbits) and thread group (18rabbits). Except normal control group, the other three groups were used Huayang absorbable ligating clip, Tyco absorbable ligating clip and thread, respectively to ligate the cystic duct and cystic artery in the direct vision cholecystectomy. The operation time, postoperative complications, intraoperative blood loss were observed at the same time.(2) Preoperation and postoperation2,3,4weeks later, vein blood from each group of animal ears were collected. The levels of IL-6, IL-8, TNF-a, PT, INR, APTT, FIB and TT were detected.(3) Preoperation and postoperation, vein blood from each group of animal ears were collected. The levels of ALT, AST, DBIL, ALP, BUN, Cr and UA in the blood serum were detected and compared with each group.(4)2,3,4weeks and2,4,6,8,10months later, three kinds lined property on the local liver and kidney changes were observed by naked eye and light microscopy morphological methods.(5)2,4,6months later, the three kinds of local retained item hepatobiliary organizational changes were checked by morphological methods of electron microscopy.Results:(1) Operation time of the three operation groups showed no significant difference. In Huayang group and Tyco group, the amount of bleeding in surgery were significantly less than that of thread group (P <0.01).There were no significant differences between Huayang group and Tyco group (P>0.05). After operation, there were no bleeding, bile leakage and other complications in each group.(2)2,3,4weeks later, the levels of IL-6, IL-8, TNF-a and prothrombin indexes of four groups were compared with each other, and had no significant difference (P>0.05).(3)The liver and renal function indexes of each group were no significant difference (P>0.05).(4)2,3and4weeks later, each group appeared different degrees of edema and then the edema dissipated after two months.Liver and kidney histological examination showed that changes of Huayang group and Tyco group were basically the same, they both showed no significant difference with the thread control group. TEM results showed that the ultra structural changes in the four groups of liver cells is basically the same, no obvious variation of the phenomenon.(5) The Huayang absorbable ligating clips and the Tyco absorbable ligating clips were degradated after4months and completely absorbed after8months, but thread knots were no significant changes.Conclusion:Huayang absorbable ligating clips are reliable to close cystic duct and blood vessels. In addition, Huayang absorbable ligating clips can be gradually absorbed after6months operation. Between the results of TEM, liver and renal biopsy, Huayang absorbable ligating clips show no obvious changes on liver and kidney tissues as well as liver cells. Meanwhile the indexes are not significant abnormal in the blood clotting, liver and kidney function tests. It shows that there are no differences in the validity and security between Huayang absorbable ligating clips and Tyco absorbable ligating clips.