LTSE及LCBDE对胆总管结石伴胆囊结石患者血清免疫球蛋白及炎症因子水平的影响

doi:10.3969/j.issn.1671-7171.2023.10.028

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Abstract 【Objective】To observe the clinical effects of laparoscopic transcystic duct lithotripsy (LTSE) and laparoscopic common bile duct lithotomy (LCBDE) on the levels of serum immunoglobulin and inflammatory factors in the treatment of choledocholithiasis complicated with cholecystolithiasis. 【Methods】Fifty patients with choledocholithiasis and cholecystolithiasis who admitted to our hospital from January 2015 to January 2019 were randomly divided into the observation group (LTSE and LCBDE) and the control group (open choledocholithotomy combined with cholecystectomy), with 25 cases in each group. The operation time, incision length, intraoperative bleeding volume, gastrointestinal recovery time and hospitalization time of the two groups were compared. The levels of serum immunoglobulin G (IgG), immunoglobulin M (IgM) and immunoglobulin A (IgA) before and after operation were analyzed. The levels of inflammatory factors C-reactive protein (CRP), interleukin-6 (IL-6), interleukin-10 (IL-10) and tumor necrosis factors in the two groups were observed. The level of tumor necrosis factor-alpha(TNF-α) was measured and the incidence of postoperative complications in the two groups was analyzed. 【Results】The operation time, incision length, gastrointestinal recovery time and hospitalization time of the observation group were significantly shorter than those of the control group (P<0.05), and the intraoperative bleeding volume was significantly lower than that of the control group (P<0.05). After operation, there were no significant differences in the levels of IgG, IgM and IgA between the observation group and the control group (P>0.05). The levels of IgG, IgM and IgA after operation in the observation group were significantly lower than those before operation (P<0.05), while the levels of IgG, IgM and IgA in the observation group were significantly higher than those in the control group (P<0.05). After operation, the levels of CRP and IL-6 in the two groups were significantly higher than those before operation (P<0.05), while the levels of IL-10 and TNF-α were significantly lower than those before operation (P<0.05). There was no significant difference in the levels of TNF-α between the two groups after operation (P>0.05).However, the levels of CRP and IL-6 in the observation group were significantly lower than those in the control group, and the level of IL-10 was significantly higher than that in the control group, and the difference was statistically significant (P<0.05). The incidence of complications in the observation group was 16.00%, which was significantly lower than 44.00% in the control group (P<0.05). 【Conclusion】Compared with traditional operation, both LTSE and LCBDE have good clinical safety in the treatment of common bile duct stones and cholecystolithiasis, have little impact on the body's immune function, and have mild inflammatory reactions in patients. It is worthy of clinical reference..

Key words： Cholecystolithiasis/CO Gallstones/CO Cholecystectomy, Laparoscopic Immunoglobulins

Received: 18 July 2022

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R575.624

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http://journal07.magtech.org.cn/yxlcyj/EN/10.3969/j.issn.1671-7171.2023.10.028 OR http://journal07.magtech.org.cn/yxlcyj/EN/Y2023/V40/I10/1540

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