Comparative Studies On Calculus Extraction Via Laparoscope Or Laparotomy Surgery

Objective:To explore the choledoch incision for stone extraction via laparoscope or laparotomy in term of their effects on body and principal mechanism.Methods:62 cases of patients with choledocholithiasis accompanying?or not?with gallstones are retrospectively analyzed,from Jan,2013 to Sep,2016 at general surgery department in our hospital.Among them 32 cases underwent laparoscopic cholecystectomy?LC?combined with laparoscopic choledoch?LCHTD?as observation group,30cases underwent cholecystectomy via laparotomy for calculus extraction and drainage as control group.Clinical data are analyzed for the patients of two groups,and postoperation pain?the recovery time for gastrointestinal function,time of getting-off for activity?length of stay?time of surgery?amount of bleeding during operation?occurrence rate of complications?and simultaneously detection of the WBC counting in peripheral blood before and immediately after operation and at 24hr,48hr as well,interleukin?cortisol?Cor?on 1st?3rd?5^th day postoperation respectively?C-reactive protein?CRP??immune globulinIgA?IgG?IgM,the above all are compared between two groups.Results:?1?.From the clinical analysis findings,the laparoscope group is superior to laparotomy group in term of postoperation pain?the recovery time for gastrointestinal function,time of getting-off for activity?length of stay?time of surgery?amount of bleeding during operation?occurrence rate of complications.?2?.WBC counting from blood cell analysis?CRP level tested by rate nephelometry method,all indicators at same observing time points before and after operation reveals laparoscope group are lower than that of laparotomy group,and also postoperative indicators in two groups exceed that before operation.?3?.The serum IL-6?cortisol inflammatory factors of the laparoscope group are lower than laparotomy group at the same observing points through ELISA detection,with the higher postoperative indicators than before in both groups.?4?.The serum immune globulin IgA?IgG?IgM of patients are tested by immune rate nephelometry method,at same observing time points all the indicators are higher than laparotomy group with the higher postoperative indicators than before in both groups.Conclusion:Laparoscopic Cholecystectomy?LC?combined with?LCHTD?have a small injury on abdominal tissues,and only a tiny harassment to abdominal viscera organs,which causes a lighter reaction in inflammatory response and immunosuppression with few complications,thus more beneficial for the patients'rehabilitation.It is a safe and effective operation,worthy of popularization and application in clinical practice.