Effects of two kinds of laparoscopic cholecystolithotomy on inflammatory factors and T lymphocyte subsets in patients with gallstones

doi:10.3877/cma.j.issn.1674-0793.2018.04.009

Abstract

Abstract:

Objective

To investigate the effects of two types of laparoscopic cholecystolithotomy on the inflammatory factors and T lymphocyte subsets in patients with cholecystolithiasis.

Methods

A prospective study was conducted, patients enrolled in gallstone from July 2016 to July 2017 in Jingmen Second People’s Hospital who underwent laparoscopic cholelithotomy, as the complete group, and those underwent laparoscopic assisted cholecystolithotomy, as the assisted group, with 50 cases in each group. The level of T lymphocyte subsets (CD3⁺, CD4⁺ and CD8⁺) and the changes of inflammatory factors were compared between the two groups.

Results

(1) Intraoperative blood loss (7.6±0.8) ml and operative time (51.38±0.9) min in the complete group were significantly lower than those in the assisted group (13.5±2.9) ml, (61.27±1.3) min, the differences were statistically significant (statistical value=44.229, 4.651, P=0.016, 0.023). (2) 1 day after surgery, CD3⁺ and CD4⁺ levels were significantly decreased, CD8⁺ level increased significantly (P<0.05). Postoperative 5 d, CD3⁺ and CD4⁺ levels in assisted group were increased, but still significantly lower than the preoperative level, while CD8⁺ was decreased, but still higher than preoperation (P<0.05). The complete group on postoperative 1 and 5 d, CD3⁺ and CD4⁺ levels were significantly higher than those of the assisted group, but CD8⁺ level lower than the assisted group, the difference was statistically significant (P<0.05). (3) The levels of Hs-CRP, IL-6 and TNF-α on postoperative 1 d in the two groups were significantly increased (P<0.05). 5 d after operation, there was no significant difference of the three indicators compared with preoperation in the complete group, while for the assisted group the three indicators were still higher than preoperation (P<0.05). The complete group was significantly lower than that of the assisted group 1 and 5 d after operation, and the differences were statistically significant (P<0.05).

Conclusion

Laparoscopic cholelithotomy is more effective than laparoscopic cholecystolithotomy, and has less influence on inflammatory factors and T lymphocyte subsets in patients.

Key words: Cholelithiasis, Laparoscopy, Cholecystolithotomy

Changsheng Shangguan, Ying Xiang. Effects of two kinds of laparoscopic cholecystolithotomy on inflammatory factors and T lymphocyte subsets in patients with gallstones[J]. Chinese Archives of General Surgery(Electronic Edition), 2018, 12(04): 251-254,288.

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Figures/Tables 4

References 15

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组别	例数	男/女（例）	年龄（岁,±s）	病程（月,±s）	结石类型（例）		结石直径（cm, ±s）	合并疾病（例）
组别	例数	男/女（例）	年龄（岁,±s）	病程（月,±s）	原发性	继发性	结石直径（cm, ±s）	高血压	糖尿病	肝功能轻度异常
完全组	50	23/27	44.5±3.9	12.97±2.96	8	42	1.31±0.33	6	5	3
辅助组	50	19/31	41.3±5.2	13.51±3.28	11	39	1.35±0.09	8	6	5
统计值		χ²=0.835	t=1.057	t=0.697	χ²=0.735		t=0.858	χ²=0.682
P值		0.529	0.516	0.687	0.491		0.397	0.565

组别	例数	男/女（例）	年龄（岁,±s）	病程（月,±s）	结石类型（例）		结石直径（cm, ±s）	合并疾病（例）
组别	例数	男/女（例）	年龄（岁,±s）	病程（月,±s）	原发性	继发性	结石直径（cm, ±s）	高血压	糖尿病	肝功能轻度异常
完全组	50	23/27	44.5±3.9	12.97±2.96	8	42	1.31±0.33	6	5	3
辅助组	50	19/31	41.3±5.2	13.51±3.28	11	39	1.35±0.09	8	6	5
统计值		χ²=0.835	t=1.057	t=0.697	χ²=0.735		t=0.858	χ²=0.682
P值		0.529	0.516	0.687	0.491		0.397	0.565

组别		手术时间（min）	术中出血量（ml）	胃肠蠕动恢复时间（d）	住院时间（d）
完全组（50例）		51.38±0.9	7.6±0.8	1.4±0.5	4.3±0.8
辅助组（50例）		61.27±1.3	13.5±2.9	1.5±0.6	4.1±0.9
	统计值	44.229	5.729^a	0.905	1.174
	P值	0.016	0.033^a	0.617	0.593

组别		手术时间（min）	术中出血量（ml）	胃肠蠕动恢复时间（d）	住院时间（d）
完全组（50例）		51.38±0.9	7.6±0.8	1.4±0.5	4.3±0.8
辅助组（50例）		61.27±1.3	13.5±2.9	1.5±0.6	4.1±0.9
	统计值	44.229	5.729^a	0.905	1.174
	P值	0.016	0.033^a	0.617	0.593

组别		CD3⁺	t值^a	P值^a	CD4⁺	t值^a	P值^a	CD8⁺	t值^a	P值^a
完全组（50例）
	术前	60.13±5.92	-	-	40.13±6.23	-	-	26.38±5.39	-	-
	术后1 d	49.82±8.23	7.191	0.035	35.28±6.16	3.914	0.023	29.12±5.95	2.413	0.044
	术后5 d	59.62±6.52	0.409	0.429	39.96±5.83	0.141	0.627	26.18±5.68	0.181	0.729
辅助组（50例）
	术前	61.53±6.09	-	-	39.86±7.19	-	-	25.96±5.52	-	-
	术后1 d	43.82±6.53	14.025	0.041	31.73±5.43	6.380	0.028	34.67±6.27	7.373	0.039
	术后5 d	55.71±5.36	5.073	0.036	36.28±7.06	2.842	0.044	28.15±5.39	2.007	0.046
t值^b,c,d		1.166, 4.038, 3.276			0.201, 3.057, 2.857			0.385, 4.540, 1.779
P值^b,c,d		0.819, 0.037, 0.034			0.619, 0.045, 0.049			0.783, 0.047, 0.038

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