| Objective: To observe weight, ghrelin levels and histopathological changes following transcatheter left gastric artery embolization in rabbit model of obesity, and evaluate its safety. Materials and Methods:Fifteen New Zealand rabbits were randomly divided into three groups, group A:left gastric artery embolization using gelatin sponge (350 ? m-560 ?m), group B:left gastric artery and gastroduodenal artery embolization using gelatin sponge (350 ? m-560 ? m), group C (control group):left gastric artery and gastroduodenal artery perfusion using normal saline (5ml), preoperative and postoperative 1,2,3,4 weeks, ghrelin, weight and liver and kidney function was measured, animals were killed 4 weeks after interventional procedure, histopathology, immunohistochemistry and western blot were performed in stomach and duodenum. Results: preoperative ghrelin level of group A was (4057 pg/ml ±61), ghrelin level of postoperative 1,2,3,4 week was (3606 pg/ml ± 119, P<0.0001), (3679 pg/ml±135, P<0.0001), (3733 pg/ml±144, P<0.0001), (3814 pg/ml± 112, P<0.0001). Preoperative ghrelin level of group B was (4137 pg/ml ±89), ghrelin level of postoperative 1,2,3,4 week was (3379 pg/ml ± 146, P<0.0001), (3469 pg/ml ±117, P<0.0001), (3684 pg/ml ± 146, P<0.0001), (3898 pg/ml ± 114, P<0.0001). Preoperative ghrelin level of control group was (3986 pg/ml ± 82), ghrelin level of postoperative 1,2,3,4 week was (4062 pg/ml±70, P>0.05), (4069 pg/ml ± 76, P>0.05), (4002pg/ml ± 73, P>0.05), (4043 pg/ml ± 73, P>0.05) Preoperative ghrelin level of group A was (4057 pg/ml ±61), average ghrelin level of postoperative was (3708 pg/ml± 141, P<0.0001), preoperative ghrelin level of group B was (4137 pg/ml ± 89), average ghrelin level of postoperative was (3608 pg/ml ±239, P<0.0001).preoperative ghrelin level of control group was (3986 pg/ml ± 82), average ghrelin level of postoperative was (4044 pg/ml ± 72, P>0.05),there were significant differences between each group (P<0.001). Preoperative weight of group A was (6.12kg±0.38), weight of postoperative 1,2,3,4 week was (5.48kg±0.37, P<0.05), (5.61kg±0.41, P>0.05), (5.73kg±0.41, P>0.05), (5.82kg±0.45, P>0.05). Preoperative weight of group B was (5.99kg ± 0.57), weight of postoperative 1,2,3,4 week was (4.86kg±0.51, P<0.01), (5.03kg±0.62, P<0.05), (5.43kg±0.61, P>0.05), (5.64kg±0.52, P>0.05). Preoperative weight of control group was (5.94kg±0.45), weight of postoperative 1,2,3,4 week was (6.06kg± 0.43, P>0.05), (6.12kg ±0.44, P>0.05), (6.33kg ±0.40, P>0.05), (6.47kg ± 0.39, P>0.05). Preoperative weight of group A was (6.12kg±0.38), average weight of postoperative was (5.66kg ± 0.39, P<0.05), preoperative weight of group B was (5.99kg ±0.57), average weight of postoperative was (5.24kg ±0.61, P<0.01), preoperative weight of control group was (5.94kg ± 0.45), average weight of postoperative was (6.24kg ±0.42, P>0.05),there were significant differences between each group (P<0.05). Postoperative liver and kidney function changes were not significantly different (P>0.05). Histopathological examination found gastric mucosa ulcer in three animals. Immunohistochemistry revealed that experimental gastric and duodenal ghrelin-expressing cells significantly reduced compared with control group (27.7±3.4 vs 10.0±5.1, P<0.0001; 12.3±2.1 vs 5.6±2.6, P<0.0001). Western blot revealed that experimental gastric and duodenal ghrelin protein bands gray ratio is significantly lower than the control group (1.12 ± 0.09 vs 0.65 ± 0.05, P<0.01; 0.94 ±0.08 vs 0.55 ± 0.03, P<0.01). Conclusions:This study revealed that ghrelin and weight decreased following left gastric artery embolization, ghrelin and weight decreased more following left gastric and gastroduodenal artery embolization than that following left gastric artery embolization, Immunohistochemistry and western blot revealed experimental gastric and duodenal ghrelin-expressing cells significantly reduced compared with control group, and histopathological examination and liver and kidney function tests suggested this technology is relatively safe, therefore it is possible that left gastric artery embolization become a minimally invasive treatment for obesity, The left gastric artery and gastroduodenal artery embolization at the same time could achieve more weight loss. |
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