Clinical efficacy and safety analysis of laparoscopic cholecystectomy in patients with chronic cholecystitis and cholecystolithiasis / 国际外科学杂志

ABSTRACT

Objective To discuss the effect of laparoscopic cholecystectomy open cholecystectomy on liver function,inflammatory factors and immunoglobulin in patients with chronic cholecystitis and cholecystolithiasis.Methods One hundred and five cases of chronic cholecystitis and cholecystolithiasis patients in the First Hospital of Danjiangkou City were selected form May 2015 to May 2017 by taking a retrospective analysis,and divided into experimental group (treated with laparoscopic cholecystectomy,n =52) and control group (treated with traditional open cholecystectomy,n =53) according to the different ways of treatment,recorded and compared the indicators of the operation process,alanine aminotransferase (ALT),aspartate aminotransferase (AST),total bilirubin (TBIL),gamma glutamyl transpeptidase (GGT),tumor necrosis factor-u (TNF-α),interleukin-6 (IL-6),interleukin-8 (IL-8),C reactive protein(CRP),IgA,IgG,IgM.The measurement data were expressed by ((x) ± s),and the t test was used comparison between groups,and the x2 test was used comparison between enumeration data,the comparison of the incidence of postoperative complications between the two groups was used the rank sum test,repeated measurement data using repeated measurement variance analysis.Results The operation time,intraoperative blood loss,postoperative anal exhaust time,first defecation time after operation,hospitalization time and hospitalization costs of experimental group were (73.71 ± 11.62) minutes,(60.73 ±6.88) ml,(24.38 ± 3.72) hours,(37.21 ±2.79) hours,(5.68 ±1.78) days,(6600 ±1 600) yuan respectively,the control group were (118.48 ±25.52) minutes,(121.24 ± 13.29) ml,(32.77 ±4.46) hours,(56.85 ±5.81) hours,(9.29 ±2.89) days,(4 900 ± 1 100) yuan respectively,which were statistically significant(the values of t were 3.584,4.183,3.397,3.245,3.489,2.938 respectively,all P ＜ 0.05).The liver function indexes ALT,AST,TBIL and GGT of the two groups were increased significantly after operation,which were statistical difference between the two groups (all P ＜0.05).The inflammatory indexes,TNF-α,IL-6,IL-8,CRP of the two groups were significantly increased,and the 1,3,5 days TNF-α,IL-6,IL-8,CRP after operation of the experimental group were significantly lower than the control group,which were statistical difference (all P ＜ 0.05).Compared with preoperative,the immunoglobulin indexes (IgA,IgG,IgM) of the experimental group after operation were no statistical difference (all P ＞ 0.05).The immunoglobulin indexes IgA,IgG,lgM in the control group were significantly lower than preoperative all P ＜ 0.05,the 1,3,5 days IgA,IgG,IgM of the control group after operation were significantly lower than the experimental group (all P ＜ 0.05).The incidence of operative complications of experimental group 5.77％ (3/52) was significantly lower than the control group 15.09％ (8/53),which was statistical difference (Z =5.118,P =0.000).Conclusion The therapeutic effect of Laparoscopic cholecystectomy on chronic cholecystitis and cholecystolithiasis is reliable,small trauma and short hospitalization time,although patients with postoperative liver function increase significantly but can be quickly restored,the level of inflammatory factors in the patients is significantly improved,and there is little effect on the immune function,and the incidence of postoperative complications is low,so it is worth popularizing in clinical practice.