LCBDE术一期缝合治疗胆总管结石患者效果研究*

doi:10.3969/j.issn.1672-5069.2023.01.033

Abstract

Abstract: Objective The aim of this study was to investigate the clinical efficacy of primary suture laparoscopic common bile duct exploration (LCBDE) in the treatment of patients with choledocholithiasis. Methods 74 patients with choledocholithiasis were encountered in our hospital between January 2018 and October 2021, and among them, 31 patients in control group were treated with T-tube drainage after LCBDE and another 43 patients in observation group were treated with primary suture LCBDE. All patients were followed-up for 6 months after operation. Serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), albumin (ALB) and total bilirubin (TBIL) levels were detected by using an automatic biochemical analyzer, and serum stress response indicators, such as adrenaline (A), adrenocorticotropic hormone (ACTH) and cortisol (COR) levels were assayed by radioimmunoassay. Results The operation time, intraperitoneal drainage time and hospital stay in the observation group were(91.3±12.6)min, (3.3±1.2)d and (5.9±1.2)d, significantly shorter than [(115.4±19.2)min, (4.5±1.4)d and (8.6±1.5)d, respectively, P＜0.05] in the control; there were no significant differences as respect to serum biochemical parameters between the two groups(P＞0.05); 3 days after operation, serum A, ACTH and COR levels in the observation were (1.2±0.3) nmol/L,(13.6±4.1)ng/mL and (212.9±21.4)ng/mL, all significantly lower than [(1.6±0.4)nmol/L, (17.2±4.8)ng/mL and (256.4±35.7)ng/mL, P＜0.05] in the control; at the end of six month follow-up, the post-operational complications in the observation was 9.3%, significantly lower than 29.0%(P＜0.05) in the control, while there was no significant difference respect to the postoperative stone recurrence in the two groups (2.3% vs. 6.5%, P>0.05). Conclusion The primary suture LCBDE is a good choice for patients with choledocholithiasis, which might relieve the postoperative stress reaction and reduce the risk of complications.

Key words: Choledocholithiasis, Laparoscopic common bile duct exploration, Primary suture, T-tube drainage, Stress response, Therapy

Zhang Fu, Chen Junmao, Liang Xiaohui. Efficacy of primary suture laparoscopic common bile duct exploration in the treatment of patients with choledocholithiasis[J]. Journal of Practical Hepatology, 2023, 26(1): 128-131.

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Efficacy of primary suture laparoscopic common bile duct exploration in the treatment of patients with choledocholithiasis

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