RESUMEN
Background: With the advancement of laparoscopic technology, the combination of laparoscopy, choledochoscopy, and holmium laser lithotripsy has emerged as an effective treatment modality for both choledocholithiasis and hepatolithiasis. This study aimed to assess the efficacy and safety of this approach. Methods: Retrospective analysis was conducted on the medical records of 76 patients diagnosed with choledocholithiasis and hepatolithiasis between April 2021 and March 2023. Patients were divided into two groups based on the treatment plan: the control group, which underwent traditional laparotomy and choledochoscopy lithotripsy (n = 38), and the experimental group, which underwent laparoscopy combined with choledochoscopy and holmium laser lithotripsy (n = 38). Comparative analysis was performed on various operation-related parameters, stone-free rate, complication rates, and changes in biochemical, liver function, inflammatory, stress response indicators, and pain scores between the two groups. Results: The experimental group demonstrated significantly shorter stone removal time, reduced intraoperative bleeding, and shorter hospital stay compared to the control group (P < 0.05). Moreover, the experimental group exhibited lower incidence of postoperative complications and lower pain scores at 2 weeks to 3 months post-operation (P < 0.05). Biochemical indicators including total bile acid (TBA), total bilirubin (TBIL), alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), and glutamyl transpeptidase (GGT) were significantly lower in the observation group compared to the control group (P < 0.05). Additionally, stress and inflammation indicators were also lower in the experimental group (P < 0.05). Conclusions: The combination of laparoscopy, choledochoscopy, and holmium laser lithotripsy presents favorable therapeutic outcomes in the management of choledocholithiasis and hepatolithiasis, indicating its potential for widespread clinical application.
RESUMEN
AIMS: The prognostic role of dickkopf-1 (DKK1) in gastric cancer (GC) remains poorly characterized. We performed a meta-analysis to evaluate correlations between DKK1 overexpression and the prognosis of patients with GC. MATERIALS AND METHODS: We included five published studies to assess the relationship between DKK1 and the clinicopathological characteristics and overall survival of GC patients. Literature searches, article selection, data collection, and statistical analysis were performed using RevMan 5.3 software. RESULTS: Our analyses revealed that DKK1 overexpression was significantly associated with vascular invasion (odds ratio [OR] = 2.43, 95% confidence interval [CI] = [1.21, 4.89], p = 0.01, random effect), lymphatic invasion (OR = 2.61, 95% CI = [1.30, 5.24], p = 0.007, random effect), and distant metastasis (OR = 2.99, 95% CI = [1.95, 4.59], p < 0.00001, fixed effect). Moreover, we also found that DKK1 overexpression was significantly associated with poor overall survival in GC patients (risk ratio = 2.67, 95% CI = [2.24, 3.48], p < 0.00001, fixed effect). CONCLUSION: This meta-analysis demonstrated that DKK1 may be a useful prognostic marker for GC.