左半肝切除术联合胆道镜治疗对复杂肝内胆管结石患者应激反应肝功能的影响研究

doi:10.3969/j.issn.1006-6233.2022.10.022

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Abstract Objective: To analyze the effects of left hemihepatectomy combined with choledochoscopy on stress response and liver function in patients with complicated intrahepatic bile duct stones. Methods: The 82 patients with complicated intrahepatic bile duct stones admitted to our hospital from January 2019 to December 2021 were retrospectively analyzed and divided into a study group (n=43,treated by laparoscopic left hepatectomy combined with choledochoscopic stone extraction) and a control group (n=39,treated by laparoscopic left hepatectomy) according to the different surgical methods.The clinical outcomes,changes in stress indicators cortisol (COR),epinephrine (EP) and C-reactive protein (CRP) before and 3d after surgery,and the levels of liver function ghrelin (ALT),serum total bilirubin (TBIL) and glutamyl transferase (GGT) before and 7d after surgery were compared between the two groups,as well as the incidence of postoperative complications such as bile leakage,infection,stone retention and pleural effusion. Results: The clinical effective rate of 93.02% in study group was higher than 76.92% in control group (P<0.05),the difference was statistically significant (P<0.05),and the efficacy grading was better than that in control group (P<0.05).The levels of COR,EP and CRP in the two groups after surgery were higher than those before surgery (P<0.05),and the differences of levels before and after surgery showed no statistical significance between the two groups (P>0.05).After surgery,the ALT,TBIL and GGT in the two groups were reduced compared with those before surgery,and the above levels were lower in study group than those in control group,and the differences of liver function indicators before and after surgery in study group were higher compared to control group (P<0.05).The total incidence rate of bile leakage,infection,residual stone and pleural effusion was 4.66% in study group,which was lower than 20.51% in control group (P<0.05). Conclusion: Laparoscopic left hemihepatectomy combined with choledochoscopy has a good clinical efficacy and has small impact on stress response in the treatment of complicated intrahepatic bile duct stones,and it can improve the liver function and reduce the complications,thus it is worthy of clinical application and promotion.

Key words： Left hemihepatectomy Choledochoscopic lithotomy Complicated intrahepatic bile duct stones Stress response Liver function

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	ZHANG Yang
	KOU Yan
	XU Chunmei

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ZHANG Yang,KOU Yan,XU Chunmei. Effects of Left Hemihepatectomy Combined with Choledochoscopy on Stress Response and Liver Function in Patients with Complicated Intrahepatic Bile Duct Stones[J]. HeBei Med, 2022, 28(10): 1696-1700.

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http://www.hbyxzzs.cn/EN/10.3969/j.issn.1006-6233.2022.10.022 OR http://www.hbyxzzs.cn/EN/Y2022/V28/I10/1696

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