腹腔镜与开腹胆囊切除术对患者术后肝功能及免疫功能的影响

目的探讨腹腔镜胆囊切除术(LC)与开腹胆囊切除术(OC)对患者术后肝功能及免疫功能的影响。方法回顾性分析我院2011年5月至2013年5月82例胆囊良性病变患者的临床资料,根据手术方式将患者分为LC组(n=49例)及OC组(n=33),比较患者肝功能及免疫功能指标的变化。结果 2组患者术后肝功能指标变化趋势相同,ALT、AST、TBIL在术后1 d较术前升高(P0.05),术后3 d开始明显下降(P0.05),术后7 d达正常水平,在2组间比较差异无统计学意义(P0.05);LC组患者术后免疫功能指标无明显变化(P0.05),OC组IgG、CD3+(%)、CD4+(%)、CD4+/CD8+在术后1 d、3 d均较术前明显降低(P0.05),术后7 d恢复至术前水平(P0.05)。结论 LC与OC均可造成患者术后短暂肝功能异常,但LC对术后免疫功能无明显影响。

Comparison between laparoscopic cholecystectomy and open cholecystectomy on liver function and immune function

Objective To compare the influence between the laparoscopic cholecystectomy （LC） and open cholecystectomy （OC） on liver function and immune function. MethodsThe clinical data of 49 cases that accepted LC and 33 cases that accepted OC were retrospectively analyzed, the changes of the liver function and immune function between the two groups were compared. Results There were the same trend of the changes of the liver function, 1 d after surgery the ALT, AST, TBIL were elevated （ P 〈 0.05 ） and decreased 3 d after surgery （ P 〈 0.05 ） , after 7 d these indicators were of the normal level, and the difference of the indicators at different time points in 2 groups was not statistically significant （ P 〉 0.05 ）. Indicators of immune function in LC group were not significantly change （ P 〉 0.05 ）. In the OC group, the IgG, CD3^＋ （ % ） , CD4^＋ （ % ） , CD4^＋/CD8^＋ on the postoperative 1 d, 3 d were significantly lower than those before surgery （ P 〈 0.05 ）. The level of indicators 7 d after operation were restored to those before surgery（ P 〉 0.05 ）. Conclusion LC surgery can cause transient liver function abnormality, but it is of no significant effect on immune function.