Joint Effect of ERCP and Holmium Laser Lithotripsy on Intestinal Mucosal Barrier Functions and Serum Inflammation Levels in Patients with Refractory Common Bile Duct Stones
Objective To analyze the joint effect of ERCP and holmium laser lithotripsy on the intestinal mucosal barrier functions and inflammation levels in patients with refractory choledochal stones.Methods Totally 120 patients diagnosed with common bile duct stones in our hospital between Jan.2021 and Dec.2023 were selected and divided by surgical methods into two groups:control group(traditional surgery group,n=60)and study group(ERCP+holmium laser lithotripsy group,n=60).The surgery-related indexes and the indexes of intestinal mucous membrane barrier functions and levels of inflammation before the surgery and 3 days after the surgery were compared between two groups.Results The operation and hospitalization durationand intraoperative bleeding of the patients in the study group were much less than those of the patients in the control group(P＜0.05).For the patients in both groups,the barrier functions of intestinal mucosa were impaired and the levels of D-lactic acid and endotoxin significantly after the surgery(P＜0.05).In addition,the level of D-lactic acid was much lower in the study group than in the control group(P＜0.05),the degree of the impairment was less severe in the study group,the improvement to the microecological environment in the intestinal tract was better in the study group after the removal of the stones,and the levelsof Lactobacillus and Bifidobacterium were higher in the study group(P＜0.05).Furthermore,the inflammation levels were elevated in both groups after the surgery,but the IL-6,IL-1β and TNF-α were significantly lower in the study group than in the control group(P＜0.05).Conclusions The combination of ERCP and holmium laser lithotripsy is worthy of recommendation as it is beneficial to patients'postoperative recovery and has less impact on patients'intestinal mucosal functions and stress responses while being compared with the traditional surgery.
ERCPHolmium laser lithotripsyCommon bile duct stonesIntestinal mucosal barrierInflammation levels
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