| Objective: Cholecystectomy is a safe and effective therapy forgallbladder diseases such as cholecyslithiasis and polyp of gallbladder. Withthe development of medical technology, people have known more about themedical knowledge, so cholecystectomy was not unfamiliar and terrible tothem. Laparoscopic techniques have perfect effect of minimally invasivesurgery. Since the first laparoscopic cholecystectomy (LC) was performed byFrench Surgeon Mouret in1987, LC was extensively developed in all over theworld. With this, the number of patients received cholecystectomy hassignificantly increased. But a lot of gastrointestinal symptoms caused bycholecystectomy, such as a change in stool, and (or) in bowel habits, or evendiarrhea, nausea, abdominal distension, upper abdominal pain, andgastrointestinal dysfunction, which have seriously affected the quality of lifeof patients. But the diarrhea is more prominent, and the public have paid moreattention to this issue. The cause of diarrhea is complicated, including highpermeability diarrhea, malabsorption diarrhea, secretory diarrhea, exudativediarrhea, infectious diarrhea and movement diarrhea, which have differentduration. Therefore, it should be paid more attention to the gastrointestinalproblems after cholecystectomy, but there is rare report about the diarrheaafter cholecystectomy at home and abroad, much less in the molecularimmunization level.5-hydroxytryptamine (5-HT) which is a kind of brain-gutpeptide closely related to gastrointestinal activities, that also known asserotonin, is an important neurotransmitter and paracrine signaling molecule,that widely existed in the central nervous system and the digestive system,regulating the gastrointestinal motility and secretory function.5-HT signalingsystem abnormality can cause gastrointestinal motility imbalance andsecretion dysfunction, leading to visceral hypersensitivity. Those abnormal factors may be closely related to functional constipation, irritable bowelsyndrome, functional diarrhea, functional dyspepsia and other functionalgastrointestinal disease. We aimed to study the changes of5-HT in theintestinal mucosa after cholecystectomy of guinea pig, and explore thepathophysiology changes of the intestinal mucosa and the clinical significance.It may provide theoretical evidence for the treatment of cholecystectomyrelated complications.Methods:40clean guinea pigs with body weight between250-300gwere randomly divided into2groups (20guinea pig per group): normalcontrol group(A) only received abdominal cavity switching operation;cholecystectomy group(B) underwent cholecystectomy. All the operationswere performed under aseptic conditions.3weeks later, guinea pigs can befeed normally and the wound healed. Then after fasting for12h and havingfree access to water, they were operated under anesthesia. Get small intestinetissues (one is30cm away from the pylorus recorded as A1or B1, the other is20cm away from the ileocecus recorded as A2or B2) and colon tissues (one is5cm away from the ileocecus recorded as A3or B3, the other is20cm awayfrom the anus recorded as A4or B4) specimens, fixed in the neutral formalinsolution for immunohistochemical stain. Immunohistochemical pictures werecollected using microscope of Olympus BX51by10×20times600×800pixel, and the pictures were analysed by Mike Audi digital medical imageanalysis system, to calculate the positive cells numbers, total area andintegrated optical density of positive objects in each image.Statistical analysis: All data are expressed as mean±standard deviation(SD). Statistical analysis on the data was performed by T-test using SPSS13.0,and P-value below0.05was considered significant.Results: Different parts of the intestinal tissue of experimental results areas follows1Small intestine that30cm away from the pylorus: the total number ofpositive cells of normal control group (A1) is5.66±1.46, the total area ofpositive objects is1437.51±283.51, the integrated optical density of positive objects is796.94±107.45. While for the cholecystectomy group(B1), the totalnumber of positive cells is6.55±1.71, the total area of positive objects is1419.61±280.41, the integrated optical density of positive objects is891.05±162.41. No significant differences in the three aspects were found bycomparing between the two groups (P>0.05).2Small intestine that20cm away from the ileocecus: the total numberof positive cells, total area and integrated optical density of positive objects innormal control group (A2) is4.54±0.99,1420.37±232.21,759.10±110.12respectively. While in the cholecystectomy group (B2), they were6.14±0.99,1702.01±377.38,996.28±239.25respectively. There were significantdifferences in the three aspects by comparing between the two groups (P<0.05).3Colon that5cm away from the ileocecus: the total number of positivecells of normal control group (A3) is6.66±1.12, the total area of positiveobjects is2146.47±470.42, the integrated optical density of positive objects is1228.77±238.06. While for the cholecystectomy group (B3), the total numberof positive cells is8.65±1.50, the total area of positive objects is2805.24±969.87, the integrated optical density of positive objects is1689.62±567.18. Significant differences in the three aspects were observedbetween the two groups (P <0.05).4Colon that20cm away from the anus: the total number of positivecells of normal control group (A4) is1.94±0.43, the total area of positiveobjects is853.44±158.85, the integrated optical density of positive objects is489.79±78.52. While for the cholecystectomy group (B4), the total number ofpositive cells is2.36±0.66, the total area of positive objects is997.45±165.60,the integrated optical density of positive objects is626.84±104.72. Significantdifferences in the three aspects were observed between the two groups (P<0.05).Conclusion: After cholecystectomy, there is no increase of5-HT in smallintestinal tissue that30cm away from the pylorus.5-HT were significantlyincreased in small intestinal tissue that20cm away from the ileocecus and the colon tissue that5cm away from the ileocecus or20cm away from the anus.After cholecystectomy some patients suffered from diarrhea may be associatedwith the increased of5-HT. |
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