Observation on the Effect of Laparoscopic Combined with Choledochoscopy for the Treatment of Obstructive Cholangitis Caused by Stones

Zhao Yingcan; Shen Dongfang; Fan Cai

doi:10.3969/j.issn.1004-5775.2025.02.011

Abstract：Objective:To explore the application value of laparoscopic combined with choledochoscopy in the treatment of obstructive cholangitis caused by stones.Methods:The clinical data of 41 patients with stone obstructive cholangitis treated by open surgery in the hospital from January 2020 to February 2023 were collected and set as the control group,and the data of 45 patients treated by laparoscopic surgery were set as the laparoscopic group.Stone removal rate,surgical conditions and complications,as well as the levels of inflammatory factors[tumor necrosis factor-alpha(TNF-α),C-reactive protein(CRP),interleukin-6(IL-6)],and liver function indexes[cholinesterase(CHE),ghrelin aminotransferase(GOT)]before and after surgery of two groups were compared.Results:The intraoperative blood loss was lower in the laparoscopic group,and the operative time,postoperative analgesia time and hospital stay were shorter than those in the control group,with statistically significant difference(t=35.379,8.216,17.905,3.708;P＜0.05).The serum levels of TNF-α,CRP and IL-6 in 2 groups were higher than those before surgery 1 and 3 days after surgery,and the increases in the laparoscopic group were lower than those in the control group,with statistically significant difference(t=5.310,3.933;t=6.880,9.072;t=3.840,4.000;P＜0.05).3 days after surgery,CHE level was higher than that before surgery.1 day after surgery,GOT level was lower than that before surgery and 1 day after surgery.The difference was statistically significant(t=0.799,1.472;P＜0.05).There was no significant difference in the total incidence of complications between the two groups(χ2=0.843,P＞0.05).Conclusion:Laparoscopic combined with choledochoscopy for lithotomy in the treatment of calculous obstructive cholangitis has a definite effect on stone removal,can improve liver function,and has high safety,especially in reducing inflammatory damage to the body and promoting early postoperative recovery.