| Objective To explore the effect of laparoscopic cholecystectomy and small-incision cholecystectomy on immune function and stress response in patients with gallstones in combination with cholecystitis. Methods Sixty-four patients with gallstones and cholecystitis, admitted to Zhoukou Hospital of Traditional Chinese Medicine from October 2016 to October 2019, were selected as research subjects to be divided, based on the different treatment methods, into an observation group (32 cases) and a control group (32 cases). The patients in the observation group were treated with laparoscopic cholecystectomy while the patients in the control group were treated with small-incision cholecystectomy. Surgery time, intraoperative blood loss, intestinal peristalsis recovery time, duration of hospitalization, immune function related indicators and stress factor levels before and after surgery were compared between the two groups. Results Compared with the control group, the surgery time in the observation group was significantly longer (t=2.269, P=0.027), the intraoperative blood loss was significantly less (t=2.915, P=0.005), and the intestinal peristalsis recovery time and duration of hospitalization were significantly shorter (t=4.454 and 5.048 respectively, both P=0.000). On day 1, 3 and 7 after surgery, the levels of CD3 + , CD4 + and CD8 + in the two groups all decreased firstly followed by an increase, and their levels in the observation group were significantly higher than that in the control group (Day 1: t=2.116, 3.219 and 3.727 respectively, P=0.038, 0.002 and 0.000 respectively; day 3: t=2.086, 2.355 and 2.879 respectively, P=0.041, 0.022 and 0.006 respectively; day 7: t=2.073, 2.578 and 2.049 respectively, P=0.042, 0.012 and 0.045 respectively). On day 1, 3 and 7 after surgery, the levels of interleukin-6 (IL-6), C-reactive protein (CRP) and tumor necrosis factor-α (TNF-α) in the two groups increased firstly followed by a decrease, and their levels in the observation group were significantly lower than that in the control group (Day 1: t=4.075, 3.209 and 5.907 respectively, P=0.000, 0.002 and 0.000 respectively; day 3: t=3.509, 3.927 and 2.621 respectively, P=0.001, 0.000 and 0.011 respectively; day 7: t=2.912, 2.170 and 2.333 respectively, P=0.005, 0.034 and 0.023 respectively). Conclusion Laparoscopic cholecystectomy in the treatment of gallstones in combination with cholecystitis can reduce intraoperative blood loss, shorten gastrointestinal peristalsis recovery time and duration of hospitalization, lower stress response and improve immune function, presenting a high value of clinical application. |
