Effect of Laparoscopic Left Hepatic Pedicle Occlusion in the Treatment of Intrahepatic Bile Duct Stones and the Influence on Liver Function and Stress Index after Operation
WUjisiguleng, ZHANG Tong, WANG Wanxiang
Affiliated Hospital of Inner Mongolia Medical University, Inner Mongolia Hohhot 010059, China
Abstract：Objective: To study the effect of laparoscopic left hepatic pedicle occlusion in the treatment of intrahepatic bile duct stones and its influence on liver function and stress index after operation. Methods: 102 intrahepatic bile duct stones who received therapy from February 2017 to February 2018 in our hospital were selected as research objects. According to random number table,those patients were divided into the observation group (n=52) and the control group (n=50). The control group was treated with laparotomy, while the observation group treated with Laparoscopic left hepatic pedicle occlusion. Then the Surgical indicators (operation time, intraoperative blood loss, time of hepatic portal exhaust, time of getting out of bed, time of hospitalization), liver function indicators of Aspartate aminotransferase (AST), alanine aminotransferase (ALT), total bilirubin (TBIL), stress indicators (adrenaline, cortisol), incidence of adverse reactions of two groups after treatment were compared. Results: After treatment, The operation time, intraoperative blood loss, portal exhaust time, ambulation time and hospitalization time in the observation group were significantly lower than those in the control group[(204.85±31.87)min vs(273.75±36.52)min,(182.47±40.32)ml vs(227.38±51.28)ml,(21.08±6.37)h vs(46.24±11.76)h,(1.94±0.42)d vs(3.02±0.61)d,(12.05±2.53)d vs(17.32±3.97)d](P＜0.05). AST, ALT and TBIL were significantly lower than those in the control group[(87.47±20.86)U/L vs(101.38±23.97)U/L,(71.97±16.42)U/L vs(90.43±17.94)U/L,(46.83±12.31)μmol/L vs(60.25±14.92)μmol/L](P＜0.05). The levels of adrenaline and cortisol in each node were significantly lower than those in the control group(P＜0.05). The total incidence of adverse reactions was significantly lower than that in the control group [5.76%(3/52)vs28.00％(14/50)](P＜0.05). Conclusion: Laparoscopic left hepatic pedicle occlusion is effective in the treatment of intrahepatic bile duct stones. It can recover quickly after operation. It can reduce the stress reaction to the body and promote the recovery of liver function. It has fewer complications and is safe and reliable.
乌吉斯古楞, 张彤, 王万祥. 腹腔镜左肝蒂阻断术治疗肝内胆管结石的疗效及对术后肝功能应激指标的影响[J]. 河北医学, 2019, 25(12): 1979-1982.
WUjisiguleng, ZHANG Tong, WANG Wanxiang. Effect of Laparoscopic Left Hepatic Pedicle Occlusion in the Treatment of Intrahepatic Bile Duct Stones and the Influence on Liver Function and Stress Index after Operation. HeBei Med, 2019, 25(12): 1979-1982.
[1] 俞渊,李敏朋,潘孟,等.原发性肝内胆管结石的病因及外科治疗新进展[J].系统医学,2018,3(18):196~198. [2] Kamiyama R, Ogura T, Okuda A, et al. Electrohydraulic lithotripsy for difficult bile duct stones under endoscopic retrograde cholangiopancreatography and peroral transluminal cholangioscopy guidance[J]. Gut & Liver, 2018, 44(12):1464. [3] 尚敏杰,张成武.肝内胆管结石的微创治疗进展[J].肝胆胰外科杂志,2016,28(5):436~438. [4] Cha S W. Management of intrahepatic duct stone.[J]. Korean Gastroenterol, 2018, 71(5):247~252. [5] 李鹏,王拥军,王文海.ERCP诊治指南(2018版)[J].中国实用内科杂志,2018,38(11):1041~1072. [6] 王坚.复杂肝内胆管结石的诊断与处理[J].中国实用外科杂志,2016,36(3):292~295. [7] Aburajab M, Dua K. Endoscopic management of difficult bile duct stones.[J]. Current Gastroenterology Reports, 2018, 20(2):8. [8] 匡远黎,王郑,杨志亮,等.腹腔镜规范化肝切除与开腹肝部分切除术对肝内胆管结石患者炎症因子、应激激素及免疫功能的影响[J].海南医学院学报,2018,24(6):700~703. [9] Sun Y, Li K, Wang Y. Primary hydatid cyst of the intrahepatic bile duct: case report[J]. Radiology of Infectious Diseases, 2018, 5(1):55~57.
2019, Vol. 25 
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