摘要
Abstract
Objective:To investigate the effects of laparoscope-guided hepatic lobectomy combined with choledochoscopic lithotomy on hepatobiliary function,stress indexes and complications in elderly patients with intrahepatic biliary stones.Method:A total of 160 elderly patients with intrahepatic biliary stones treated in Hezhou Hospital of Traditional Chinese Medicine from March 2020 to October 2022 were selected and divided into two groups according to random number table method.All patients underwent laparoscope-guided hepatic lobectomy,and the control group(n=80)underwent transhepatic cholangiolithotomy,the observation group(n=80)underwent choledochoscopic lithotomy.Perioperative period indexes,hepatobiliary function,stress indexes and complication rate were compared between the two groups.Result:The intraoperative bleeding volume in the observation group was less than that in the control group,the postoperative exhaust time was earlier than that in the control group,postoperative hospital stay was shorter than that in the control group,the differences were statistically significant(P<0.05).There were no significant differences in hepatobiliary function indexes between the two groups before surgery(P>0.05).After surgery,the total bilirubin(TBIL),direct bilirubin(DBIL),alanine aminotransferase(ALT),aspartate aminotransferase(AST),alkaline phosphatase(AKP)and γ-glutamyltransferase(GGT)in both groups were lower than those before surgery,and TAIL,BILL,ALT,AST,AKP and GGT in observation group were significantly lower than those in control group,the differences were statistically significant(P<0.05).There were no significant differences in adrenaline and heart rate before surgery between the two groups(P>0.05).After surgery,the above stress indexes in both groups were increased,but adrenaline and heart rate in the observation group were lower than those in the control group(P<0.05).The complication rate of observation group was lower than that of control group(P<0.05).Conclusion:Laparoscope-guided hepatic lobectomy+choledochoscopic lithotomy in the treatment of intrahepatic biliary stones can improve the hepatobiliary function,relieve the stress reaction and reduce the occurrence of complications.关键词
腹腔镜引导肝叶切除术/胆道镜取石术/肝内胆管结石/并发症Key words
Laparoscope-guided hepatic lobectomy/Choledochoscopic lithotomy/Intrahepatic biliary stones/Complication
