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Chinese Journal of Operative Procedures of General Surgery(Electronic Edition) ›› 2019, Vol. 13 ›› Issue (05): 472-475. doi: 10.3877/cma.j.issn.1674-3946.2019.05.014

Special Issue:

• Original Article • Previous Articles     Next Articles

Postoperative early period liver function of patients with choledocholithiasis and cirrhosis after laparoscopic and ERCP treatment

Bo Cao1, Xiang Li1, Kefei Chen2,()   

  1. 1. Department of General Surgery, Meishan Hospital of Traditional Chinese Medicine, Sichuan 620010, China
    2. Department of General Surgery, West China Hospital, Sichuan 610041, China
  • Received:2018-12-14 Online:2019-10-26 Published:2019-10-26
  • Contact: Kefei Chen
  • About author:
    Corresponding author: Chen Kelin, Email:
  • Supported by:
    Scientific research projects (popularization and application projects) of Sichuan Health and Family Planning Commission(NO.18PJ506)

Abstract:

Objective

To investigate the postoperative early period liver function of patients with choledocholithiasis and cirrhosis after laparoscopic and ERCP treatment.

Methods

From January 2015 to June 2018, clinical data of 42 patients with choledocholithiasis and cirrhosis treated by laparoscopy plus ERCP(combined group) or laparotomy (open group) were analyzed retrospectively. SPSS 19.0 software was used for data analysis. Measurement data such as surgical indicators, inflammatory response and liver functions were expressed as (±s) and were examined by independent t test. The Calculi clearance rate and postoperative complications were examined by chi square test or Fisher exact test. A P value of <0.05 was considered as statistically significant.

Results

There was no significant difference in operation time between the two groups (P>0.05). The intraoperative blood loss, postoperative hospitalization time and the total incidence of postoperative complications in the combined group were significantly lower than those in the open group respectively (P<0.05). At 3 days after operation, the inflammatory reaction (PCT, CRP, IL-6) of the two groups were all increased, while more change in open group (P<0.05). The indexes of liver function (Child-Pugh score, MELD score and MELD-Na score) of the two group were decreased after operation (P<0.05), while less change in combined group (P< 0.05).

Conclusion

Laparoscopy + ERCP has a better therapeutic effect of patients with choledocholithiasis and liver cirrhosis, which could reduce surgical trauma, inflammatory reaction, postoperative complications and could alleviate postoperative liver function injury.

Key words: Choledocholithiasis, Liver cirrhosis, biliary, Cholangiopancreatography, endoscopic retrograde, Laparoscopes, Laparotomy

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