Effects of Complete Laparoscopic Common Bile Duct Exploration on Elderly Patients with Complicated Hepatolithiasis and Their Inflammatory Stress Response Index and Immune Function
TANG Bing-lin;Department of General Surgery,Yuechi County People's Hospital;
Objective To study the effects of complete laparoscopic common bile duct exploration on elderly patients with complicated hepatolithiasis and their inflammatory stress response index and immune function.Methods 64 cases of the elderly patients( over 60 years old) diagnosed with complicated hepatolithiasis in our hospital were selected and randomly divided into two groups. 32 cases of patients treated with complete laparoscopic common bile duct exploration was enrolled in the laparoscopic group,and the other 32 cases treated with traditional open surgery were classified as the open group. The curative effects of the two groups were compared. Results The operation time,intra-operative blood loss,postoperative anal exhaust time,hospital stays and medical costs in the laparoscopic group were shorter or less than those in the open group( P 0. 05). The levels of total bilirubin,direct bilirubin and indirect bilirubin of two groups one month after the operation were significantly decreased( P 0. 05),and the declines in the open group was lower than those of the laparoscopic group( P 0. 05). The levels of EP,CO,IL-6 and CRP in the two groups were significantly increased while the levels of CD3~+,CD4~+,CD8~+and CD4~+/CD8~+were significantly decreased,and the changes in the open group were significantly higher than those of the laparoscopic group( P 0. 05). The total incidence rates of postoperative complications in the laparoscopic group and the open group were 9. 38% and 25% respectively,and the recurrence rates were 6. 25% and 15. 63% respectively,indicating the difference was not statistically significant( P 0. 05). There were significant differences in immunological stress index between the complication,relapse cases and therapeutic cases( P 0. 05).Conclusion Complete laparoscopic common bile duct exploration has reliable effects in treatment of elderly patients with complicated hepatolithiasis with the benefits of minimal invasion,short operation time,rapid postoperative recovery,small influence on stress response and improved immune function in patients after the operation. It can also reduce the postoperative complications and the recurrence rate. Therefore,complete laparoscopic common bile duct exploration has a high value in clinical promotion.
【CateGory Index】： R657.42