| Summary: | 碩士 === 長庚大學 === 臨床醫學研究所 === 90 === Background/Purpose：
Postoperative cholangitis is one of the most common complications after bile duct reconstruction. The pathogenesis and early consequences of ascending cholangitis still are unidentified.
Methods :
Male Sprague-Dawley rats were divided into 5 treatment groups : control (n=4), blood sampling and liver biopsy only; group I, [BDL/Escherichia coli; n=6], ligation of common bile duct (BDL) for a week, followed by Roux-en-Y choledochojejunostomy (RYCJ) and injection of E coli (ATCC 25922) into Roux limb after 24 hours; group II, [BDL/NS; n=5], same procedures as in group I, with injection of normal saline (NS) into Roux limb; group III, [SBDL/E coli; n=6], primary RYCJ was constructed 1 week after sham ligation of common bile duct (SBDL) followed by the same treatment as group I; Group IV, [SBDL/NS; n=6], same procedures as in group III, but injecting NS into Roux limb. All animals were killed after 24 hours of treatment. Blood was sampled for culture and serum cytokine levels. The liver was harvested for quantitative bacterial culture, as well as for MCP-1, interleukin (IL)-8 (CINC in the rat) and transforming growth factor β1 mRNA expression by reverse transcriptase polymerase chain reaction (RT-PCR) and for immunohistochemistry. The choledochojejunostomy was resected for culture. Serum cytokine levels were detected by ELISA kits.
Results :
A significant increase of E coli ATCC 25922, occurred in the livers of group I rats, compared with group IV(P=0.037). MCP-1 expression increased in all groups, compared with control (P=0.000). The IL-8 mRNA expression was significantly higher in group I than in control (P=0.021). The expression of TGF-β1 mRNA was similar among the groups (P=0.361), consistent with the immunohistochemistry results. The serum MCP-1 and IL-8 levels were higher in the 4 groups than in the control (P=0.000) and were significantly higher in group I than in group IV (P=0.001).
Conclusions :
This study found that a significant colonization of E coli of the same strain was present in the cholestatic rat liver injected into the Roux limb, which was associated with a higher expression of liver MCP-1 and IL-8 mRNA, a significant increase of serum MCP-1 and IL-8, and a more evident inflammatory cell infiltration into the porta hepatis.
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