Analysis of the effect of laparoscopic partial hepatectomy combined with fibrocholedochoscopy in the treatment of hepatolithiasis
Objective To explore the effect of laparoscopic partial hepatectomy combined with fibrocholedochoscopy in the treatment of hepatolithiasis.Methods 72 patients with hepatolithiasis were randomly divided into a control group and an observation group,with 36 cases in each group.The control group was treated with open partial hepatectomy combined with fibrocholedochoscopy,and the observation group was treated with laparoscopic partial hepatectomy combined with fibrocholedochoscopy.The surgical indicators(operation time,intraoperative blood loss,postoperative anal exhaust time,ambulation time and hospitalization time),complications,inflammatory factors,stone residue and recurrence were compared between the two groups.Results In the observation group,the operation time was(152.43±23.64)min,the postoperative anal exhaust time was(19.46±4.31)h,the ambulation time was(12.07±2.23)h and the hospitalization time was(6.58±1.24)d,which were all shorter than(208.37±26.95)min,(29.28±6.39)h,(26.51±3.76)h and(10.67±2.03)d in the control group;the intraoperative blood loss of(55.16±13.09)ml in the observation group was less than(83.75±18.57)ml in the control group(P<0.05).The complication rate of 5.56%in the observation group was lower than 27.78%in the control group(P<0.05).3 d after surgery,the observation group had CRP of(26.83±3.90)mg/L,white blood cell count(WBC)of(9.39±1.46)×109/L and interleukin-6(IL-6)of(82.98±9.16)ng/ml,which were lower than(39.43±5.16)mg/L,(11.83±1.78)×109/L and(120.46±11.62)ng/ml in the control group;the interleukin-10(IL-10)of(35.97±8.74)pg/ml in the observation group was higher than(30.12±6.59)pg/ml in the control group(P<0.05).The stone residue rate and recurrence rate in the observation group was similar to that in the control group,and the difference was not statistically significant(P>0.05).Conclusion Laparoscopic partial hepatectomy combined with fibrocholedochoscopy is effective in the treatment of hepatolithiasis,with less trauma,less postoperative inflammatory reaction,faster recovery,lower incidence of complications,and lower stone residue and recurrence.
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