The Therapeutic Effect Of Interrupt Peritoneal Lavage Combined With Antibiotic On Sever Acute Pancreatitis In Rats

Objective:To evaluate the therapeutic effect of interrupt peritoneal lavage(PL) combined with antibiotics on the severe acute pancreatitis by the experimental severe acute pancreatitis in rats, which may provided theoretical evidences for the clinical application of peritoneal lavage.Methods:Fifty-six adult Wistar rats (280g-350g) were randomly divided into sham operation(SO) group; SAP groups included non-antibiotic+non-drainage tube (SNANT) group、non-antibiotic+drainage tube(SNAT) group、antibiotic+drainage tube (SAT) group and antibiotic+non-drainage tube(SANT); and SAP+PL groups included antibiotic+peritoneal lavage (APL) group and non-antibiotic+peritoneal lavage(NAPL) group, with8rats in each group. SNANT and SANT models were produced by slow retrograde infusion of5%sodium taurocholate solution (0.02ml/100g) into the common biliopancreatic duct in Wistar rats. In the SNAT、SAT、APL and NAPL groups, abdominal cavity drainage tube with side holes was introduced into the abdominal cavity at the right lower quadrant of the abdomen based on the SNANT models, and was tied to the rat tail. Peritoneal lavage was performed with normal saline at ambient temperature and narcosis after12hours of successful induction of animal models, once per12hours and four times in total. The intraperitoneal injection of antibiotics (Left oxygen Buddha injection40mg/kg+Metronidazole Injection90mg/kg) was performed once in every12hours after successful induction of animal models in SANT and SAT groups or next to the termination of peritoneal lavage in APL group. Blood sample and pancreatic tissue were obtained after12hours of injection of antibiotics and peritoneal lavage, respectively. The blood levels of tumor necrosis factor-a (TNF-a), Interleukin-6(IL-6), Interleukin-8(IL-8), lipopolysaccharide (LPS) were measured by enzyme-linked immunosorbent assay (ELISA). The changes of pathological morphology of pancreatic tissue were evaluated and scored under light microscope after staining with hematoxylineosin-stain.Results:(1) Compared with the SO group, the blood levels of TNF-a、 IL-6、IL-8、LPS in SAP groups and SAP+PL groups were increased remarkably (P<0.05); Compared with the SNANT group, there were no significantly changes (P>0.05) in the SNAT group and the NAPL group and Compared with the SANT group, there were no significantly changes (P>0.05) in the SAT group and the APL group for the blood levels of TNF-a、IL-6、IL-8、LPS.But compared to the groups without antibiotics including SNANT group, SNAT group and NAPL group, the blood levels of TNF-a、IL-6、IL-8、LPS in the groups with antibiotics including SANT group, SAT group and APL group were decreased remarkably (P<0.05); while compared with the NAPL group, the blood levels of TNF-a、IL-6、IL-8、LPS in the APL groups were decreased remarkably (P<0.05).(2) The histological examination of pancreatic tissue shows that:the enlargement of interlobular space, inflammatory infiltration, fat necrosis, hemorrhage, and the destruction or deletion of pancreatic acini were observed in the SAP groups; while in the SAP+PL groups, the enlargement of interlobular space is larger than the SAP groups, but there was no significantly changes (P>0.05) for the inflammatory infiltration, fat necrosis, hemorrhage, and the destruction or deletion of pancreatic acini between them; there was only dispersive regional edema of interlobular space in the SO group. The total histopathologic scores were significantly increased in SAP groups and PL groups compared to SO group (P<0.05), and there is no statistically significant differences between SAP groups and PL groups (P>0.05).Conclusion:This study suggest that, in the early stage of SAP, interrupt peritoneal lavage combined with antibiotics reduces significantly the blood levels of TNF-a、IL-6、IL-8and LPS(P<0.05), and maybe contributed to amelioration of prognosis of SAP.