Effect of endoscopic retrograde cholangiopancreatography on serum amyloid A, C-reactive protein and endothelin-1 in patients with acute gallstone cholangitis / 中华内分泌外科杂志

ABSTRACT

Objective To observe the efficacy of endoscopic retrograde cholangiopancreatography (ER-CP) and laparotomy in treatment of acute gallstone cholangitis and their impact on the levels of serum amyloid A (SAA),C-reactive protein (CRP) and endothelin-1 (ET-1).Methods 80 patients with acute gallstone cholangitis,from Jan.2013 to Dec.2016,were divided into observation group(35 cases) and the control group (45 cases)according to the surgical procedure.The observation group received ERCP,and the control group were performed with open cholecystectomy,common bile duct extraction and T-tube placement.The operation time,blood loss,gastrointestinal function recovery time,hospital stay,and the success rate of stone removal,and the levels of SAA,and changes in CRP and ET-1 before and after treatment were observed in each group.Results Compared with the control group,the observation group had shorter operative time [(76.43±9.82)min vs (69.28±7.53) min,P=0.000],less blood loss[(1 1.73±2.83)ml vs (78.41±3.28) ml,P=0.000],shorter gastrointestinal function recovery time [(29.53±3.27) h vs (78.33±8.43) h,P=0.000],and shorter hospital stay [(5.73±1.32)d vs (8.54±1.62) d,P=0.000],while the success rate of stone removal was not significantly different between the two groups (97.14％ vs 95.56％,P＞0.01).Before treatment,the levels of SAA,CRP and ET-1 had no significant difference between the two groups(P＞0.05).The levels of SAA,CRP and ET-1 in the two groups after treatment were significantly lower than those before treatment (P＜0.01),while the levels decreased more in the observation group compared with that in the control group (P＜0.01).Conclusions The endoscopic therapy and laparotomy in treatment of acute cholangitis stones have both achieved good efficacy.Compared ith laparotomy,ERCP has faster recovery,shorter hospital stay,and quicker subsided inflammation.