Effects of two kinds of laparoscopic cholecystolithotomy on inflammatory factors and T lymphocyte subsets in patients with gallstones

Objective To investigate the effects of two types of laparoscopic cholecystolithotomy on the inflammatory factors and T lymphocyte subsets in patients with cholecystolithiasis. Methods A prospective study was conducted, patients enrolled in gallstone from July 2016 to July 2017 in Jingmen Second People’s Hospital who underwent laparoscopic cholelithotomy, as the complete group, and those underwent laparoscopic assisted cholecystolithotomy, as the assisted group, with 50 cases in each group. The level of T lymphocyte subsets (CD3+, CD4+ and CD8+) and the changes of inflammatory factors were compared between the two groups. Results (1) Intraoperative blood loss (7.6±0.8) ml and operative time (51.38±0.9) min in the complete group were significantly lower than those in the assisted group (13.5±2.9) ml, (61.27±1.3) min, the differences were statistically significant (statistical value=44.229, 4.651, P=0.016, 0.023). (2) 1 day after surgery, CD3+ and CD4+ levels were significantly decreased, CD8+ level increased significantly (P<0.05). Postoperative 5 d, CD3+ and CD4+ levels in assisted group were increased, but still significantly lower than the preoperative level, while CD8+ was decreased, but still higher than preoperation (P<0.05). The complete group on postoperative 1 and 5 d, CD3+ and CD4+ levels were significantly higher than those of the assisted group, but CD8+ level lower than the assisted group, the difference was statistically significant (P<0.05). (3) The levels of Hs-CRP, IL-6 and TNF-α on postoperative 1 d in the two groups were significantly increased (P<0.05). 5 d after operation, there was no significant difference of the three indicators compared with preoperation in the complete group, while for the assisted group the three indicators were still higher than preoperation (P<0.05). The complete group was significantly lower than that of the assisted group 1 and 5 d after operation, and the differences were statistically significant (P<0.05). Conclusion Laparoscopic cholelithotomy is more effective than laparoscopic cholecystolithotomy, and has less influence on inflammatory factors and T lymphocyte subsets in patients. Key words: Cholelithiasis; Laparoscopy; Cholecystolithotomy