Clinical effect of ERCP on choledocholithiasis after cholecystectomy and its influence on immune function and hepatobiliary index

doi:10.3877/cma.j.issn.1674-3946.2021.03.028

Abstract

Abstract:

Objective

To investigate the clinical effect of ERCP on choledocholithiasis after cholecystectomy and its influence on immune function and hepatobiliary index.

Methods

86 cases of choledocholithiasis after cholecystectomy were collected in our hospital from January 2014 to December 2018 and randomly divided into ERCP group and Laparoscopic group, 43 cases in each group. The ERCP group was treated with ERCP, while the Laparoscopic group was treated with conventional laparoscopic exploration. Spss23.0 software was used for statistical analysis. The total effective rate, stone residual rate, stone recurrence rate, biliary stricture rate, cholangitis rate, and the total incidence of adverse events were measured by chi square test; T lymphocyte level and liver function index were measured by independent t test. The difference was statistically significant (P<0.05).

Results

The effective rate of ERCP group(97.7%) was higher than that of laparoscopic group (81.4%), and the incidence of adverse reactions(7.0%) was lower than that of laparoscopic group (28.0%) (P.The changes of CD3⁺, CD4⁺ and CD8⁺ T lymphocyte levels in the ERCP group were less than those in the Laparoscopic group. After treatment, the serum GPT, AST, TBA and other liver and gallbladder fsunction indexes were lower than those in the Laparoscopic group, with statistical significance (P<0.05).

Conclusion

ERCP has a good clinical effect on choledocholithiasis after cholecystectomy. It can effectively reduce the liver and gallbladder index and has little influence on the immune function of patients.

Key words: Choledocholithiasis, Cholecystectomy, Cholangiopancreatography, endoscopic retrograde, Treatment outcome, Immune function, Hepatobiliary index

Fengjiao Zhang, Qu Liu, Caide Liu. Clinical effect of ERCP on choledocholithiasis after cholecystectomy and its influence on immune function and hepatobiliary index[J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2021, 15(03): 339-342.

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References 23

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组别	例数	年龄(岁)	性别(例)	胆总管结石数(枚)	胆总管直径(cm)
组别	例数	年龄(岁)	男/女	胆总管结石数(枚)	胆总管直径(cm)
腹腔镜组	43	65.2±6.7	23/20	2.8±0.5	2.2±0.7
开腹组	43	64.6±6.3	22/21	2.6±0.5	2.1±0.7
t/χ²值		0.428	0.047	1.855	0.662
P值		>0.05	>0.05	>0.05	>0.05

组别	例数	年龄(岁)	性别(例)	胆总管结石数(枚)	胆总管直径(cm)
组别	例数	年龄(岁)	男/女	胆总管结石数(枚)	胆总管直径(cm)
腹腔镜组	43	65.2±6.7	23/20	2.8±0.5	2.2±0.7
开腹组	43	64.6±6.3	22/21	2.6±0.5	2.1±0.7
t/χ²值		0.428	0.047	1.855	0.662
P值		>0.05	>0.05	>0.05	>0.05

组别	例数	显效	缓解	无效	总有效率
ERCP组	43	27(62.8)	15(34.9)	1(2.3)	42(97.7)
腹腔镜组	43	21(48.8)	14(32.6)	8(18.6)	35(81.4)
χ²值					6.081
P值					<0.05

组别	例数	显效	缓解	无效	总有效率
ERCP组	43	27(62.8)	15(34.9)	1(2.3)	42(97.7)
腹腔镜组	43	21(48.8)	14(32.6)	8(18.6)	35(81.4)
χ²值					6.081
P值					<0.05

组别	例数	结石残留	结石复发	胆管狭窄	胆管炎	其它	总发生率
ERCP组	43	1(2.3)	1(2.3)	0(0.0)	1(2.3)	0	3(7.0)
腹腔镜组	43	3(7.0)	2(4.7)	2(4.7)	2(4.7)	3(7.0)	12(28.0)
χ²值							6.541
P值							<0.05

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