Feasibility of dual-lens simultaneous treatment of gallstones complicated by extrahepatic cholangiolithiasis and its effects on immune function of patients

WANG Jingjing

doi:10.3969/j.issn.1002-7386.2018.13.013

Abstract：Objective To investigate the therapeutic effects of laparoscopy combined with choledochoscopy or duodenoscopy on gallstones complicated by extrahepatic cholangiolithiasis and its effects on immune function of patients. Methods A total of 82 patients with gallstones complicated by extrahepatic cholangiolithiasis were randomly divided into two groups according to random digital table, with 41 patients in each group. The patients in group A were treated by laparoscopic cholecystectomy (LC) combined with choledochoscopy,however,the patients in group B were treated by LC combined with duodenoscopy. The operation related indexes, postoperative complications, proportion of T lymphocytes and the levels of immunoglobulin before and after operation were observed and compared between two groups. Results The operation was performed successfully in the patients of both groups,and there were no significant differences in operation time,intraoperative blood loss, stone clearance rate, stone residual rate, the proportion of transit patients, postoperative out of bed time, gastrointestinal function recovery time,postoperative complications between two groups (P＞0. 05). As compared with that in group A,the duration of hospitalization in group B was significantly shortened,but the cost of hospitalization was significantly increased (P＜0. 01). Moreover the levels of CD+4,CD+8and IgG,IgA and IgM at 1 day after operation were significantly decreased in both groups,as compared with those before operation (P＜0. 05 or P＜0. 01),however there were no significant differences between two groups (P＞0. 05). Conclusion LC combined with choledochoscopy or duodenoscopy in treatment of gallstones complicated by extrahepatic cholangiolithiasis can obtain better therapeutic effects, but the surgery cost of LC combined with choledochoscopy is relatively lower, and the hospital stay of patients after operation of LC combined with duodenoscopy is shorter.