Effect of Combination Three-Lens Surgery on Patients with Extrahepatic Biliary Calculi and Hepatobiliary Indexes
Objective:To explore the clinical efficacy of combined three-lens surgery(laparoscopy,duodenoscope,choledochoscope)in the treatment of patients with extrahepatic biliary calculi and its influence on hepatobiliary indexes.Methods:The clinical data of 90 patients with extra-hepatic biliary stones admitted to Jiangxia District Hospital of Traditional Chinese Medicine in Wuhan City from May 2020 to June 2023 were selected as the study objects,and they were divided into a two-unite groups(n=47)and a trimodality groups(n=43)according to different treatment regimens.The trimodality group were treated with the combination of three lens surgery and the two-unite group were treated with the combination of two mirrors(laparoscopy and choledochoscopy).The total effective rate,perioperative indexes,hepatobiliary indexes,stress indexes inflammatory factors and complications of the two groups were compared and observed.Results:One week after operation,the total effective rate of treament in the trimodality group was 95.35%,which was higher than 80.85%of the two-unite group,the difference was statistically significant(P<0.05).The operation time of the trimodality group was longer than that of the two-unite group,the intraoperative blood loss in the timedality group was more than that of the two-unite group,and the operation time,the first exhaust time,the first getting out of bed activity and the length of hospital stay were shorter than those of the two-unite group,the differences were statistically significant(P<0.05).One week after surgery,the levels of liver and bile indexes in 2 groups were lower than before surgery,and the trimodality groups were lower than the two-unite group,the differences were statistically significant(P<0.05).There were no significant differences in the level of stress indexes between the two groups before and 1 week after surgery(P>0.05).One week after surgery,the levels of cortisol and norepinephrine in 2 groups were higher than before surgery,and the levels of natural killer autocyte were lower than before surgery,with statistical significance(P<0.05).One week after operation,the levels of inflammatory factors in both groups were higher than those before operation,with statistical significance(P<0.05).The incidence of complications in the trimodality group was 6.97%,which was lower than 23.40%in the two-unite group,the difference was statistically significant(P<0.05).Conclusion:Three mirrors combined treatment of extrahepatic biliary calculi is effective,safe and feasible.This method can not only improve the perioperative indexs,liver function and bile biochemical indexes,but also reduce the incidence of postoperative complications.
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