Exploring the safety of laparoscopic common bile duct exploration for the treatment of complex hepatolithiasis and its impact on the quality of life of patients
Objective To explore the safety and feasibility of laparoscopic common bile duct exploration for the treatment of complex hepatolithiasis.Methods 92 patients with complex hepatolithiasis were selected and divided into a control group(n=46)and an observation group(n=46)by odd-even number method.The control group was treated with open common bile duct exploration,and the observation group was treated with laparoscopic common bile duct exploration.The perioperative indicators,serum stress response indicators,bilirubin levels,inflammation and quality of life at various stages were compared between the two groups.Results The operation time and postoperative hospitalization time were(160.30±19.83)min and(11.70±2.08)d in the observation group,which were shorter than(213.26±28.70)min and(16.21±3.10)d in the control group;the intraoperative blood loss of(57.92±15.11)ml in the observation group was less than(89.53±17.31)ml in the control group;the complication rate of 4.35%in the observation group was lower than 17.39%in the control group(P<0.05).There was no significant difference in serum stress response indicators between the two groups before surgery(P>0.05).5 d after surgery,the observation group had malondialdehyde(MDA)of(4.03±1.15)μmol/L and oxidized low-density lipoprotein(ox-LDL)of(62.76±4.15)μg/L,which were lower than(5.98±1.52)μmol/L and(73.09±5.30)μg/L in the control group;the paraoxonase 1(PON-1)of(112.71±11.56)U/L in the observation group was higher than(101.91±9.36)U/L in the control group(P<0.05).There was no significant difference in the level of bilirubin between the two groups before surgery(P>0.05).5 d after surgery,the levels of direct bilirubin(DBil),total bilirubin(TBil)and indirect bilirubin(IBil)in the observation group were(17.31±2.30),(25.15±1.97)and(25.50±1.18)μmol/L,which were lower than(21.41±2.63),(31.80±2.02)and(30.23±2.95)μmol/L in the control group(P<0.05).There was no significant difference in the level of inflammation between the two groups before surgery(P>0.05).5 d after surgery,IL-6 and CRP in the observation group were(63.35±7.38)ng/ml and(21.35±0.47)mg/L,which were lower than(81.57±9.43)ng/ml and(49.78±0.52)mg/L in the control group;IL-10 of(37.52±8.21)pg/ml in the observation group was higher than(31.89±5.36)pg/ml in the control group(P<0.05).There were no significant differences in quality of life scores between the two groups before surgery(P>0.05).3 months after surgery,the scores of self-conscious symptoms,physical physiological function,physiological emotional status and daily function in the observation group were(3.12±0.49),(3.01±0.27),(3.20±0.30)and(3.16±0.28)points,which were higher than(2.02±0.69),(2.38±0.12),(2.17±0.28)and(2.75±0.40)points in the control group(P<0.05).Conclusion Laparoscopic common bile duct exploration has a high safety for complex hepatolithiasis,and this surgical procedure has a minor effect on the patient's postoperative stress and inflammation,which helps to restore bilirubin to normal levels and promotes prognosis.
Laparoscopic common bile duct explorationOpen common bile duct explorationComplex hepatolithiasisSafetyQuality of life
万方数据
维普
