Department of General Surgery, Atrium Health Wake Forest Baptist, Winston-Salem, NC, USA.
Am Surg. 2023 Jul;89(7):3171-3173. doi: 10.1177/00031348231161688. Epub 2023 Mar 3.
Laparoscopic cholecystectomy (LC) with laparoscopic common bile duct exploration (LCBDE) is gaining traction for the management of choledocholithiasis. Liver function tests (LFTs) are often used to determine the success of ductal clearance, yet the impact of differing therapeutic interventions, endoscopic retrograde cholangiopancreatography (ERCP) or LCBDE, have on postprocedure LFT is insufficiently described. We hypothesize that these interventions have different postoperative LFT profiles. The preprocedural and postprocedural total bilirubin (Tbili), aspartate aminotransferase (AST), alanine aminotransferase (ALT), and alkaline phosphatase (ALP) were analyzed of 167 patients who had successful ERCPs (117) or LCBDEs (50). Endoscopic retrograde cholangiopancreatography patients demonstrated a significant decrease in all LFTs postprocedure (n = 117; = <0.001 for all) with a continued downtrend when a second set of LFTs was obtained (n = 102; = <0.001 for all). For successful LC+LCBDEs, there was no significant change between preoperative and 1st postoperative Tbili, AST, ALT, and ALP and the 2nd postoperative labs.
腹腔镜胆囊切除术（LC）联合腹腔镜胆总管探查术（LCBDE）在治疗胆总管结石方面越来越受到关注。肝功能检查（LFTs）常用于确定胆管清除的效果，但不同治疗干预措施（内镜逆行胰胆管造影术 [ERCP] 或 LCBDE）对术后 LFT 的影响描述不足。我们假设这些干预措施具有不同的术后 LFT 特征。分析了 167 例成功进行 ERCP（117 例）或 LCBDE（50 例）的患者的术前和术后总胆红素（Tbili）、天门冬氨酸氨基转移酶（AST）、丙氨酸氨基转移酶（ALT）和碱性磷酸酶（ALP）。ERCP 组（n = 117）所有 LFTs 在术后均显著下降（ < 0.001 ），当再次进行 LFT 检查时（n = 102）仍呈持续下降趋势（ < 0.001 ）。对于成功的 LC+LCBDE，术前和术后第 1 天的 Tbili、AST、ALT 和 ALP 以及第 2 天的实验室检查均无显著变化。
