Gabexate mesylate thermo-sensitive in-situ gel is effective for treating grade-III pancreatic trauma in beagle dogs guided by contrast-enhanced ultrasound

Abstract

Background: This study evaluates the efficacy of gabexate mesylate thermosensitive in-situ gel (GMTI) in the treatment of beagle grade III pancreatic trauma (PT) with the assistance of contrast-enhanced ultrasound (CEUS) and investigates its mechanism of action.

Methods: A grade III PT model consisting of 15 beagle dogs with severed main pancreatic ducts was created and treated with cephalic vein injection of gabexate mesylate (GM) (1.54 mL/10 kg, TID) and peripancreatic injection of GMTI (4.63 mL/10 kg, QD) guided by CEUS within 24 h post-surgery. Ascites and serum levels of amylase (AMY), lipase (LPS), C-reactive protein (CRP), interleukin (IL)-6, tumor necrosis factor (TNF)-α, and urinary trypsinogen activating peptide (TAP) were detected by ELISA. Histopathological changes in the canine pancreas were observed by Hematoxylin and Eosin staining.

Results: CEUS accurately displayed pancreatic lesions and guided catheterisation. Compared to the control group, the ascites was significantly reduced after treatment (p < 0.01). AMY and LPS ascites significantly decreased on post-operative 1st and 2nd day (p < 0.01). The levels of AMY, LPS, CRP, IL-6, and TNF-α in serum were decreased (p < 0.05 or p < 0.01). Urinary TAP was decreased 1 and 2 days after treatment (p < 0.05 or p < 0.01, respectively). In the control group, pancreatic tissue necrosis was evident in the wound area. Normal glandular cell structures and fibrous tissue hyperplasia were observed in the wound area after GMTI treatment. The GMTI group performed better than the GM group in improving pancreatic histology and reducing AMY levels in the early post-operative period.

Conclusion: Guided by CEUS, daily peripancreatic injections of GMTI in Beagles effectively inhibit pancreatic enzyme activity and aid in the adjuvant treatment of pancreatic trauma.

Keywords

contrast-enhanced ultrasound / Gabexate mesylate / pancreatic enzyme inhibitor / temperature sensitive gel / trauma

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