| Objective:Ampulla being obstructed can cause cholestasis and pancreatic juice regurgitation. Both cholestasis and pancreatic juice regurgitation cause acute cholecystitis. But there are no report about role in which pancreatic juice regurgitation play acute cholecystitis'pathogenesis. This study adopt rabbit as experiment's object,through common duct obstruction ,at the same time injecting pancreatic fluid ,to produce an animal model of acute cholecystitis, observe the differences in the morphologic change of gall bladder and amylase's activity of bile in gallbladder, quantity of macrophage in cholecyst and tumor necrosis factor- a (TNF- a )in blood serum and cholecyst .So this experiment's main objective is to know the role in which pancreatic juice regurgitation play this acute cholecystitis'pathogenesis , provide the animal experiment's evidence about acute cholecystitis by pancreatic juice regurgitation because of ampulla being obstructed,for example calculus. This experiment's main objective is also to provide a new channel about pancreatic cholecystitis'animal experiment,deepen the cognition about acute cholecystitis'pathogenesis.Methods: 45 healthy rabbits weighing 2.0-3.0Kg are randomly divided into three groups equally, The sham operation group(SO group), the group of bile duct ligation (BDL group), the group of common duct ligation and injecting pancreatic fluid(model group or M group).The number is 15 in each group . Each rabbit is put to death after three days. All rabbits are prohibited to eat but not prohibited to drink before operation. Operation course of M group,the first step is to intravenous anesthesia using 3% Pentobarbita(l30-35mg/kg),and to cut the middle of superior belly open in asepsis condition ,then separate inferior segment of bile duct. The second step is to ligate bile duct near gap of duodenum firstly, then puncture on the anodic of ligating bile duct using aseptic puerile transfusion needle. The next step is to ligate lightly on the anodic of puncture using silk suture (not make bile leak out),then elicit 0.2ml bile using a 1ml aseptic syringe. The third step is to inject 0.2m(lsaturation 50U/ml)pancreatic fluid to bile duct using 1ml aseptic syringe on the speed of 0.1ml/min,then pull out transfusion needle and ligate . Close the abdominal cavity after making sure no blood and no bile leaking out. Operation course of SO group is to anesthesia and cut the belly on the same condition open, then separate inferior segment of bile duct and ligate bile duct near gap of duodenum. Operation course of SO group is to only separate inferior segment of bile duct, not to ligate bile duct.After creating model, lay them into the cage and observe general state of health .The treating group animal were killed after three day. All group of rabbits get vein blood before executing and centrifuge. Radition immunity chemistry measure the blood serum TNF-a. Cull the cholecyst after executing , make them prepare olefin slice. Adhibit immunity chemistry measure the cholecyst's macrophase. Adope a little of cholecyst to measure the TNF- a in it. Take suction bile in gallbladder to measure amylase's activity. All experimental data is expressed as mean+standard deviation. The statistic significance is analyzed by SPSS 13.0 a statistic sofeware. It is considered having statistic significance as P<0.05.Results: 1 Morphologic change of gall bladder:1.1 M group macroscopic observation: the volume of rabbit's gallbladder obviously increased. Gallbladder adhered with surrounding organs, have some pus spots with different area on the basalar portion ,which is gloomy . Gallbladder have small ulcers . Biles are dark green and prasinous. Gallstones are to shape.Under light microscope, membrana mucosa epithelium are shedding severly, even depletion. Blood vessel is dilated and congestive. Membrana mucosa,tunica propria,muscular layer and placenta percreta are hydropic severly. A lot of inflammatory cell infiltrated. Muscular layer vagued. Also peribiliary inflammation appearance.1.2 BDL group macroscopic observation: the volume of rabbit's gallbladder increased,Gallbladder don't adhered with surrounding organ, have no pus spots. Membrana mucosa integrate,parietes are hydropsia and dark. Gallbladder have no ulcer . Biles are dark green and prasinous. No gallstones is to shape.Under light microscope , membrana mucosa epithelium are shedding slightly. Blood vessel is dilated and congestive. Membrana mucosa,tunica propria,muscular layer and placenta percreta are hydropic. A small quantity inflammatory cell infiltrate .1.3 SO group macroscopic observation: the volume of rabbit's gallbladder is normal. Gallbladder don't adhered with surrounding organ, have no pus spots. Membrana mucosa integrate. Gallbladder have no ulcer . Biles are prasinous. No gallstones is to shape.Under light microscope , membrana mucosa epithelium are integrated. Blood vessel is no congestive. Membrana mucosa,tunica propria,muscular layer and placenta percreta are no hydropic.2 Amylase's activity of bile in gallbladder: In M group ,the value of amylase's activity is much higher than which in BDL group and SO group(P<0.05).The value of amylase's activity in BDL group have no obviously distinction than which in SO group(P<0.05).3 TNF-a:In M group , the value of TNF-a in blood serum is much higher than which in BDL group and SO group(P<0.05).The value of amylase's activity in BDL group also higher than which in SO group(P<0.05). The value of TNF-a in cholecyst ,in M group , is much higher than which in BDL group and SO group (P<0.05). The value of amylase's activity in BDL group also higher than which in SO group(P<0.05).4 Macrophage:In M group and the BDL group,the value of Macrophage in membrana interstitial tissue and submucous membra are much higher than SO group(P<0.05) . In M group, the value is much higher than the BDL group(P<0.05).Conclusions:1 Pancreatic juice regurgitation aggravate acute cholecystitis induced by common duct obstruction. When pancreatic juice regurgitation, morphologic change of gall bladder display inflammation obviously2 When pancreatic juice regurgitation, the value of macrophage in cholecyst and TNF-a in blood serum and cholecyst increase all the better , which means that pancreatic juice regurgitation aggravate acute cholecystitis induced by common duct obstruction.
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