Application effect of self-made gauze strip in reducing the residual stone rate after laparoscopic common bile duct exploration for intrahepatic cholelithiasis
Application effect of self-made gauze strip in reducing the residual stone rate after laparoscopic common bile duct exploration for intrahepatic cholelithiasis
Objective To investigate the effect of self-made gauze strip in reducing the residual stone rate after laparoscopic common bile duct exploration(LCBDE)for intrahepatic cholelithiasis.Methods A total of 40 patients diagnosed with chole-docholithiasis combined with multiple intrahepatic bile duct stones by computed tomography(CT),magnetic resonance imaging(MR I)and magnetic resonance cholangiopancreatography(MRCP)admitted to the Department of General Surgery of Shangrao Central Hospital from July 2020 to January 2023 were selected as the study objects,they were divided into gauze strip group and non-gauze strip group according to random number table method,with 20 cases in each group.Both groups underwent LCBDE surgery.After choledocholithiasis was removed,self-made gauze strip was used to fill the lower segment of the common bile duct before choledocholithiasis exploration and treatment by choledochoscopy in gauze strip group,while gauze strip was not used in the non-gauze strip group.The treatment conditions of the two groups were compared(operation time,postoperative exhaust time,times of lithotripsy by T-duct choledochoscopy,length of hospital stay).The intestinal bar-rier function(D-lactic acid,endotoxin)were compared between the two groups before and 3 days after operation.The rate of residual stone was compared between the two groups at 6 months after operation.Results The operative time,postoperative exhaust time and hospital stay of patients in the gauze strip group were shorter than those in the non-gauze strip group,and the number of lithotripsis by T-tube choledochoscope was less than that in the non-gauze strip group,the differences were statistically significant(P＜0.05).At 3 days after operation,the levels of D-lactic acid and endotoxin in two groups were higher than those before operation,but the levels of D-lac-tic acid and endotoxin in gauze strip group were lower than those in non-gauze strip group,and the differences were statistically significant(P＜0.05).The rate of residual stone in the gauze strip group was lower than that in the non-gauze strip group,and the difference was statistically significant(P＜0.05).Conclusion The use of self-made gauze strips in the treatment of intrahepatic cholelithiasis with LCBDE can effectively shorten the operation time,promote the recovery of post-operative gastrointestinal function,and effectively reduce the rate of postoperative residual stone,which is worthy of clinical application.
关键词
自制纱布条/腹腔镜胆总管探查术/肝内胆管结石/残石率/术后恢复
Key words
Self-made gauze strip/Laparoscopic common bile duct exploration/Intrahepatic bile duct stone/Residual stone rate/Postoperative recovery
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