Effects Of NS VS 5% Mannitol On Hepatic Function As Irrigation In Postoperative Choledochoscopy

Background: The effect of choledochoscopy is well known to us, and choledochoscopy is applied in hepatic biliary surgery widely. But there are little reports on research of irrigation of choledochoscopy.Objective: To investigate which irrigation has a greater effect on hepatic function, NS or 5%mannitol? In order to provide scientific basis for selecting irrigation of choledochochoscopy.Methods: select 30 cases who underwent the bile duct exploration because of biliary stones and over 4 weeks after operations, and have normal hepatic function before choledochoscopy. Exclusion criteria: any cases who has chronic liver disease and heart or kidney disease, and the case who is checked over 2 hours or applied irrigation over 3000ml. 30 cases were selected by the criteria, and 15 cases were applied NS as irrigation, the other 15 cases were applied 5%mannitol. Choledochoscopies were preformed by same surgeon, applying the same 4mm Olympus XP20 TV-fibro-choledochoscopy, and kept same height from the lowest level of 3L bag to median axillary's line. The peripheral venous blood was sampled in the earlymorning before choledochoscopy, and at the first day, the third day and the fifth day after choledochoscopy to determine serum ALT, AST, ALP, TBIL, DBIL and other blood indexes.Results: There were no significant differences of age structure and peri-choledochoscopy hepatic function, the consuming volume of irrigation, the wasting time of choledochoscopy between NS and 5%mannitol group. There were no significant changes of serum ALT, AST, ALP, TBIL, DBIL and HCT between pre-choledochoscopy and Id, 3d after choledochoscopy in NS group, and in 5%mannitol group. There were no significant differences of serum ALT, AST, ALP, TBIL, DBIL at the first day, the third day after choledochoscopy between two groups.Conclusion: (1) Both NS and 5%mannitol have no significant effects on hepatic function;they all can be applied as irrigation in choledochoscopy. (2) 5%mannitol can be applied widely in choledochoscopy as a new and nonelectrolyte irrigation.