The Function Of Trimebutine Maleate To The Gallbladder Contraction After Cholecystolithotomy Remaining Gallbladder In Dog

Cholecystolithiasis has become one of the common and frequently-occurring diseases nowadays. For more than one hundred years, cholecystectomy has been regarded as the gold standard of treatment for cholecystolithiasis, under the guidance of"hotbed theory"put forward by Langenbuch. However, as the lucubration of gallbladder functions and the complications after cholecystectomy went deep, such as dyspepsia, reflux gastritis, and exaltation of morbidity of colon cancer and so on, some scholars have brought forward cholecystolithotomy remaining gallbladder. Therefore, in the early stage of post-operation, due to the damage and irritation to gallbladder caused by the operation, edema of gallbladder wall, drainage and adhesion nearby the gallbladder, change of diet or other factors as well, the gallbladder contraction would always be inhibited in different degrees, and the time of inhibition is mostly more than one week, resulting in cholestatis, or even biliary sludge. While the malfunction of gallbladder contraction is one of the most important reasons for gallstone reformation and recurrence, so it is greatly significant to prevent the recurrence of gallstones by using drugs or other treatment to promote gallbladder contraction and to recover gallbladder function soon after cholecystolithotomy remaining gallbladder. There is few research on the drugs that can promote gallbladder contraction at present, in spite of some medicines which have been proved by scholars'experiments and studies at home and abroad to have advantages for gallbladder contraction, for example, ectogenic CCK, cholinomimetic drugs, erythromycin, etc, but their clinical application is neither generalized nor can meet the need owing to drug security, curative effect, untoward effect and cost.OUr research evaluates the functions of drugs in gallbladder contraction after cholecystolithotomy remaining gallbladder, in order to screen out some drugs effective in gallbladder contraction postoperative recovery as fast as possible. Meanwhile, the research on the feasibility of evaluating the function of drugs in gallbladder contraction by measuring cholecystic pressure provides an effective experimental method in carrying out the research of screening out the drug that can promote gallbladder contraction during animal experiments in the future.ObjectiveTo study the function of trimebutine maleate(TM) in the dog gallbladder contraction after the operation of remaining gallbladder, and to research upon the feasibility of the experimental method, which evaluates drug function on gallbladder contraction by measuring cholecystic pressure with pressure transducer.MethodsFourteen dogs were randomly divided into 2 groups on average, which were the experimental group and the control group. The gallbladder was cut off and then suture in laparotomy state. After that, one venous catheter needle(1.0×32mm) was inserted into the gallbladder and connected with pressure transducer. Through the gastric tube, 250mL physiological saline was firstly poured into all the dogs, the change of the cholecystic pressures recorded; then 250mL physiological saline, in which 300mg TM dissolved, was poured into the ones in the experimental group, while 250mL milk into the others in the control group. Afterwards, the changes of the cholecystic pressures were recorded respectively.ResultThe changes of cholecystic pressures after the perfusion of TM and milk through the gastric tube were (2.093±0.153)mmHg and (2.730±0.169)mmHg, which were significantly higher than those of the ones only with physiological saline in their group(P<0.05), and the latter was more significant than the former(P<0.05). Besides, it took (47.9±3.9)min to reach the minimum of cholecystic pressure changing for the former, which was longer than for the latter (38.1±2.9)min(P<0.05).Conclusions1. The perfusion of TM make cholecystic pressure raise after the operation of remaining gallbladder, prompting that TM can promote gallbladder contraction. The administration of TM may promote the recovery of gallbladder function in the early stage of post-operation.2. The perfusion of milk can make gallbladder contraction and cholecystic pressure raise, but its action time is shorter than the ones of perfusing TM. While the function of TM to gallbladder contraction is weaker than milk, with longer of action time.3. The experimental method of evaluating drug function on gallbladder contraction by measuring cholecystic pressure with pressure transducer is effective and feasible.