Analysis of the efficacy and safety of laparoscopy combined with duodenoscope for patients with gallbladder stones and extrahepatic bile duct stones
Objective To analyze the clinical effect and safety of laparoscopy combined with duodenoscope for patients with gallbladder stones and extrahepatic bile duct stones.Methods A total of 103 patients with gallbladder stones and extrahepatic bile duct stones were selected and divided into an observation group(61 cases,laparoscopic combined duodenoscopic cholecystectomy)and a control group(42 cases,conventional open surgery)according to different surgical methods.Both groups were compared in terms of perioperative indicators[operation time,length of hospital stay,blood loss,postoperative visual analogue scale(VAS)score,stone clearance rate],serum stress indicators[tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),C-reactive protein(CRP),cortisol(Cor)],liver function indicators[alanine aminotrasferase(ALT),aspartate transaminase(AST),gamma-glutamyltransferase(GGT)],and complication rate.Results The stone clearance rate of both groups was 100.0%,and there was no significant difference(P>0.05).The observation group had operation time of(96.3±7.5)min and length of hospital stay of(7.5±2.1)d,which were shorter than(119.2±10.2)min and(9.4±1.2)d in the control group;the observation group had less blood loss of(25.8±5.4)ml than(46.3±6.9)ml in the control group,and lower VAS score of(2.9±0.8)points than(3.4±0.7)points in the control group(P<0.05).Before surgery,there were no significant differences in serum levels of TNF-α,IL-6,CRP and Cor between two groups(P>0.05).7 d after surgery,the serum levels of TNF-α,IL-6,CRP and Cor in both groups were significantly higher than those before surgery,but the observation group was significantly lower than the control group(P<0.05).Before surgery,there were no significant differences in ALT,AST and GGT between the two groups(P>0.05).7 d after surgery,the observation group had ALT of(43.9±4.3)U/L,AST of(40.4±4.1)U/L and GGT of(154.2±12.9)U/L,which were lower than(56.9±6.4),(49.2±5.1)and(193.3±26.5)U/L in the control group(P<0.05).The incidence of complications in the observation group was 4.92%,which was much lower than 21.43%in the control group,and the difference was statistically significant(P<0.05).Conclusion The use of laparoscope and duodenoscope in the treatment of patients with gallbladder stones combined with extrahepatic bile duct stones can improve perioperative indicators,alleviate postoperative stress reactions,promote postoperative recovery,and reduce the risk of complications,which is worthy of clinical promotion.
LaparoscopyDuodenoscopyCholecystectomyGallbladder stonesExtrahepatic bile duct stonesSafetyEfficacy
万方数据
维普
