关键词: 胆石症, 腹腔镜, 十二指肠镜, 内镜下逆行胆汁引流, 视黄醇结合蛋白, 细胞因子, 生命质量

Abstract: Objective The purpose of this study was to observe the role of indomethacin in dealing with patients with cholecystolithiasis and choledocholithiasis after gastroduodenoscopy and endoscopic retrograde biliary drainage (ERBD) operation. Methods 120 patients with cholecystolithiasis and common bile duct stones were recruited in our hospital between February 2017 and April 2018, and they were randomly divided into control and observation group received gastroduodenoscopy and ERBD, and post-operational indomethacin anastomosis for 7 days. Serum retinol-binding protein (RBP), tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6) and IL-8 levels were detected, and quality of life (QOL) score was evaluated. Result The surgical operation in the two groups was successful; at the end of 7 days after operation, serum RBP level in the observation group was (45.8±3.2)mg/L, significantly higher than 【(32.5±3.2) mg/L, P<0.05】 in the control, while serum TNF-α, IL-6 and IL-8 level were (2.1±0.4)μg/L, (15.8±7.8)μg/L and (11.6±9.5)μg/L, significantly lower than 【(4.1±0.4)μg/L, (30.8±7.7)μg/L and (37.6±9.5)μg/L, respectively, P＜0.05】 in the control; three months post-operation, the incidences of biliary stricture, incision infection, residual stones and bile leakage in the two groups was not significantly different(P＞0.05); at the end of one month and three months after operation, the QOL scores in the observation group were (45.8±3.2) and (47.2±3.0), much higher than 【(32.5±3.3) and (36.1±3.1), respectively, P＜0.05】 in the control. Conclusion The role of indomethacin is obvious in patients with Choledocholithiasis after surgical operation, which might help elevate serum RBP level, decrease serum cytokine levels and improve QOL.

Key words: Choledocholithiasis, Laparoscopy, Duodenoscopy, Endoscopic retrograde biliary drainage, Retinol binding protein, Cytokines, Quality of life