Clinical study of"three-needle"suture for laparoscopic choledocholithiasis surgery
Objective To study the clinical effect of"three-needle"suture for laparoscopic choledocholithiasis surgery.Methods Fifty patients with choledocholithiasis treated in Lianyungang Hospital of Traditional Chinese Medicine Affiliated to Nanjing University of Chinese Medicine from August 2018 to May 2022 were selected and were divided into an observation group and a control group according to the random number table method,with 25 cases in each group.In the observation group,13 males and 12 females were(48.62±13.76)years old,and the course of disease was(4.91±1.02)years.In the control group,12 males and 13 females were(49.35±15.08)years old,and the course of disease was(5.05±1.13)years.All patients underwent laparoscopic choledocholithiasis surgery.The control group underwent conventional choledochal suture,and the observation group underwent"three-needle"suture.The operation time,intraoperative blood loss,postoperative catheterization time,postoperative drainage volume,and hospital stay were compared between the two groups.The levels of procalcitonin(PCT),C-reactive protein(CRP),alanine aminotransferase(ALT),aspartate aminotransferase(AST),and total bilirubin(TBIL)were detected before and 1 month after operation in two groups.The incidence of complications within 1 month after operation was counted.t test and x2 test were used.Results The operation related indexes in the observation group were better than those in the control group(all P＜0.05).The levels of inflammatory factors were significantly lower in both groups 1 month after operation than those before operation,and those in the observation group were lower than those in the control group[PCT:(1.28±0.21)μg/L vs.(1.42±0.22)μg/L;CRP:(27.34±4.72)mg/L vs.(30.19±5.03)mg/L](t=2.302 and 2.066,both P＜0.05).The liver function indexes of both groups were significantly improved 1 month after operation,and the improvement degree of the observation group was significantly better than that of the control group[ALT:(61.38±10.06)U/L vs.(70.23±12.53)U/L;TBIL:(44.37± 7.41)μmol/L vs.(50.43±9.43)μmol/L;AST:(63.25±10.54)U/L vs.(70.61±13.92)U/L](t=2.754,2.526,and 2.108;all P＜0.05).The total incidence of postoperative complications in the observation group was12.00％(3/25),which was significantly lower than that in the control group[36.00％(9/25)](x2=3.947,P=0.047).Conclusion"Three-needle"suture for laparoscopic choledocholithiasis surgery is less traumatic,which can effectively reduce the inflammatory response,can promote the liver function recovery,has fewer postoperative complications,and is worthy of clinical promotion.
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