Effects of laparoscopy combined with choledochoscopy on inflammatory factors and complications in patients with cholecystolithiasis and choledocholithiasis
Objective To explore the effects of laparoscopy combined with choledochoscopy on inflammatory factors and complications in patients with cholecystolithiasis and choledocholithiasis.Methods A total of 80 patients with cholecystolithiasis and choledocholithiasis admitted from February 2018 to June 2022 were selected as the study objects.The patients were randomly divided into laparoscopy group and double-mirror group,with 40 cases in each group.The laparoscopy group was treated with laparoscopy,and the double-mirror group was treated with laparoscopy combined with choledochoscopy.The therapeutic effects of the two groups were compared.Results There were no significant differences in operation time and intraoperative blood loss between the two groups(P>0.05);the bed rest time,bowel sound recovery time,drainage tube indwelling time and hospitalization time of the double-mirror group were shorter than those of the laparoscopy group(P<0.05).The stone clearance rate of the double-mirror group was higher than that of the laparoscopy group,the total incidence of complications was lower than that of the laparoscopy group(P<0.05).After surgery,the levels of tumor necrosis factor-α(TNF-α),C-reactive protein(CRP),interleukin-17(IL-17),norepinephrine(NE),cortisol(Cor)and C-peptide(CP)in the double-mirror group were lower than those in the laparoscopy group,and the differences were statistically significant(P<0.05).After surgery,the levels of angiotensin 1-7(Ang1-7),angiotensin Ⅰ(AngⅠ),angiotensin Ⅱ(AngⅡ),total bilirubin(TBIL),indirect bilirubin(IBIL)and direct bilirubin(DBIL)in the double-mirror group were lower than those in the laparoscopy group(P<0.05).Conclusion Laparoscopy combined with choledochoscopy can shorten the rehabilitation cycle of patients with cholecystolithiasis and choledocholithiasis,reduce the risk of complications,improve the stone clearance rate,reduce postoperative inflammation and stress response,and improve hepatobiliary function.It is worthy of promotion and application in clinical practice.
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