腹腔镜胆道探查取石术与传统开放手术对机体创伤和免疫影响的研究.docVIP

腹腔镜胆道探查取石术与传统开放手术对机体创伤和免疫影响的研究 作者 作者单位 王草叶 南京医科大学第一附属医院，江苏 南京，210029 孙跃明　　南京医科大学第一附属医院，江苏 南京，210029 Research on operative wound and immune function change between laparoscopic choledochotomy and conventional choledochotomy WANG Caoye,SUN Yueming.Dept.of Minimal Invasive Surgery，the First Affiliated Hospital of Nanjing Medical University,Nanjing 210029,China 【Abstract】 Objective:To evaluate and compare the operative wound and immune function change between laparoscopic choledochotomy and conventional choledochotomy.Methods:From May 2008 to Oct.2008, the clinical data of 20 cases receiving laparoscopic choledochotomy were compared with 20 cases receiving conventional choledochotomy.40 patients were divided into two groups，the laparoscopic group(LG) and conventional group(CG).Each group had been operated by the same operation group.The differences in laboratory result and clinical data of these two groups were examined and compared.Results:The levels of plasma proinflammatory factors,such as TNFα,IL6,WBC,NE%,L%,BG,CRP,IgG,IgA,IgM,C3,C4,CD3+,CD4+,CD8+,CD3+CD4+/CD3+CD8+and clinic data,such as the operating time,postoperation hospitalization,the average bleeding volume,complication,the wound incision length showed that LG were better than CG.Conclusions:The differences between the two groups are significant,and LG has its fabulous advantages.The bleeding volume,incision length,average hospital stay and postoperative recovery in laparoscopic choledochotomy were superior to those in the open operation.Furthermore,the laboratory examination of stress and immune indicators shows that laparoscopic choledochotomy can reduce stress and protect body immune system better than traditional operation.Although the technical difficulty in laparoscopic choledochotomy approach was greater,the operating efficiency was better than that via the open approach.The laparoscopic choledochotomy possesses less injury and hospital stay,rapid recovery bet