双镜联合胆总管探查一期缝合术治疗胆囊结石合并胆总管结石的随访研究

A Follow-Up Study on the Treatment of Cholecystolithiasis Combined with Choledocholithiasis by Double Endoscopy Combined with Primary Suture of Common Bile Duct Exploration

目的:探讨双镜联合胆总管探查一期缝合术对胆囊结石合并胆总管结石患者炎性因子及恢复情况的影响。方法:选取2019年1月~2022年1月本院收治的74例胆囊结石合并胆总管结石患者为研究对象,依据随机数字表法均分为对照组和观察组,两组均给予腹腔镜胆囊切除联合胆道镜胆总管探查术取石,在此基础上,对照组行T管引流术,观察组行一期缝合技术,比较两组术后恢复情况,术前与术后3d肿瘤坏死因子、C反应蛋白、白细胞介素-6、白细胞计数及并发症。结果:观察组各项临床指标恢复时间均短于对照组,与术前比,术后2d两组血清TNF-α、CRP、IL-6、WBC水平均呈上升趋势,观察组低于对照组(P<0.05)。结论:双镜联合胆总管探查一期缝合术可以加快胆囊结石合并胆总管结石患者的治疗进程,缩短住院时间,减轻炎症反应。

Objective:To investigate the effect of dual endoscopy combined with primary suture of common bile duct exploration on inflammatory factors and recovery in patients with gallbladder stones and common bile duct stones.Methods:74 patients with cholecystolithiasis and choledocholithiasis admitted to our hospital from January 2019 to January 2022 were selected as the study subjects.They were divided into a control group and an observation group according to a random number table method.Both groups were treated with laparoscopic cholecystectomy combined with choledochoscopy for choledocholithiasis extraction.On this basis,the control group received T-tube drainage,and the observation group received primary suture technology.Both were observed until discharge and followed up for two months.Compare the postoperative recovery,TNF,and TNF between the two groups before and 3 days after surgery-α,CRP,IL-6,white blood cell count,and complications during follow-up.Results:The recovery time of various clinical indicators in the observation group was shorter than that in the control group,and the serum TNF levels in the two groups were 2 days after surgery compared with those before surgery-α,the levels of CRP,IL-6,and WBC all showed an upward trend,and the observation group was lower than the control group(P<0.05).Conclusion:Double endoscopy combined with primary suture for common bile duct exploration can accelerate the treatment process of patients with gallbladder stones and common bile duct stones,shorten hospital stay,and reduce inflammatory reactions.