Comparison of the Effects of Laparoscopic Cholecystectomy Using the Posterior and Anterior Triangular Approaches for the Treatment of Gallstones Complicated with Chronic Cholecystitis
Objective:Analysis of the clinical effects of laparoscopic cholecystectomy (LC) using the posterior and anterior triangular approaches for the treatment of gallstones complicated with chronic cholecystitis.Method:A total of 105 patients with gallstones complicated with chronic cholecystitis admitted to Wushan County Second People's Hospital from June 2020 to January 2023 were selected,and they were randomly divided into control group (n=52) and observation group (n=53) using the random number table method.The control group underwent LC through the anterior triangular approaches of the gallbladder,while the observation group underwent LC through the posterior triangular approaches of the gallbladder.The postoperative follow-up was 3 months,and the surgical related indicators,inflammatory factor levels,immune function,and complications were compared between the two groups.Result:The intraoperative bleeding in the observation group was less than that in the control group,and the surgery time,gastrointestinal function recovery time,and hospitalization time were shorter than those in the control group,the differences were statistically significant (P<0.05).Before surgery,there were no statistically significant differences in the levels of the C-reactive protein (CRP),tumor necrosis factor-α (TNF-α),procalcitonin (PCT),CD3+,CD4+and CD8+(P>0.05).After 1 d of surgery,CRP,TNF-α,PCT and CD8+in both groups were higher than those before surgery,while CD3+and CD4+were lower than those before surgery,but CRP,TNF-α,PCT and CD8+were lower in the observation group than those in the control group,CD3+and CD4+were higher than those in the control group,the differences were statistically significant (P<0.05).The incidence of complications in the observation group was lower than that in the control group,the difference was statistically significant (P<0.05).Conclusion:LC through the posterior triangular approaches of the gallbladder is effective in treating patients with gallstones complicated with chronic cholecystitis,which can reduce bleeding,shorten surgical time,alleviate inflammatory reactions,reduce damage to the immune system,and have fewer complications.
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