ABSTRACT
Objective:To investigate the clinical difference between primary suture and T tube drainage in laparoscopic choledocholithotomy.Methods:The clinical data of 124 patients treated by laparoscopic choledocholithotomy in Suzhou Municipal Hospital from December 2018 to February 2020 were retrospectively studied. The patients were divided into the primary suture group (71 cases) and the T tube drainage group (53 cases) according to the different surgical methods, and the differences in the relevant treatment indicators were compared between the two groups.Results:There were no statistically significant differences between the two groups in gender, hypertension, diabetes mellitus, preoperative aspartate aminotransferase, preoperative alanine aminotransferase, preoperative total bilirubin, preoperative common bile duct diameter, postoperative length of stay, total cost of hospitalization, postoperative exhaust time, or postoperative biliary leakage, et al. Compared with the T tube drainage group, the primary suture group had more single choledocholithiasis before operation (33 cases vs. 15 cases), shorter operation time: (100.14 ± 38.90) h vs. (140.45 ± 54.17) h, less intraoperative bleeding: (35.70 ± 30.17) ml vs. (49.53 ± 34.58) ml, and later extraction time of Winslow hole drainage tube after operation: (7.15 ± 2.61) d vs. (5.45 ± 3.35) d, and the differences were statistically significant ( P<0.05). Conclusions:Under the condition of strictly controlling the indications of primary suture and being operated by general surgeons who can skillfully operate laparoscope and choledochoscope, laparoscopic choledocholithotomy for primary suture has better curative effect than T tube drainage, and has higher clinical application value.
ABSTRACT
Objective To research the clinical application value of laparoscopic bile duct exploration and the first stage suture for choledocholithiasis. Methods The clinical data of 86 patients with choledocholithiasis were analyzed retrospectively from January 2015 to January 2017 in Affiliated Suzhou Hospital of Nanjing Medical University. According to the different methods of laparoscopic bile duct exploration, they were divided into one stage suture group (observation group, 46 cases) and T tube drainage group (control group, 40 cases). Results The recovery time of gastrointestinal function, hospitalization time and hospitalization expenses in observation group were significantly better than those in control group: (22.71 ± 10.92) h vs. (35.63 ± 11.12) h, (8.4 ± 2.6) d vs. (13.5 ± 2.3) d and (12.1 ± 3.2) thousand yuan vs. (13.5 ± 4.2) thousand yuan, and there were statistical differences (P＜0.05). Conclusions Compared with T tube drainage, the first stage suture after laparoscopic common bile duct exploration has shorter hospitalization time, lower treatment cost and faster recovery. It is a safe and feasible operation method, and is worthy of popularization and application.
ABSTRACT
Objective To investigate the level of chemotactic factors(CXCL5 and CXCL8)in hepatic fibrosis and cirrhosis tissue.Methods Hepatic tissues were obtained from 9 patients with hepatic hemangioma (hepatic hemangioma group),10 patients with liver fibrosis(liver fibrosis group)and 11 patients with liver cirrhosis(1iver cirrhosis group)at Nanfang Hospital from May 2008 to May 2009.The contents of CXCL5 and CXCL8 in hepatic tissue were assayed by ELISA.All data were analyzed by one-way ANOVA,Pearson rank correlation or Spearman correlation.Results The contents of CXCL5 and CXCL8 were(0.8±0.7)ng/g and(6.2±3.7)ng/g in hepatic hemangioma group,(2.0±2.0)ng/g and(11.6±3.5)ng/g in liver fibrosis group and (17.1±4.8)ng/g and(12.3±3.9)ng/g in liver cirrhosis group,with significant difference among the 3 groups (F=60.050,7.690,P＜0.05).The expression of CXCL5 was correlated with the content of alanine aminotransferase(ALT),aspartate aminotransferase(AST)and prothrombin time(PT)(r=0.502,0.468,0.523,P＜0.05):the expression of CXCL8 was correlated with the content of ALT,AST.total bilirubin and PT(r=0.477,0.504,0.537,0.431,P＜0.05).Conclusions With the aggravation of hepatic fibrosis,the contents of CXCL5 and CXCL8 are increased with different patterns.The changes of CXCL5 and CXCL8 are related with the injury of liver,but the changes of CXCL5 and CXCL8 do not correspond with the degree of the injury of liver.