Evaluation of the stress response and immune response after percutaneous transhepatic gallbladder puncture combined with laparoscopic surgery for acute severe cholecystitis

摘要

Objective: To study the stress response and immune response after percutaneous transhepatic gallbladder puncture combined with laparoscopic surgery for acute severe cholecystitis. Methods: A total of 86 patients with severe acute cholecystitis who received surgical treatment in Yulin Second Hospital between April 2013 and April 2017 were selected as the research subjects and randomly divided into two groups, observation group of patients received percutaneous transhepatic gallbladder puncture combined with laparoscopic surgery, control group of patients received emergency laparoscopic surgery, and serum was collected the same day and 3 d after operation to determine the inflammation indexes, stress response indexes and immune response indexes. Results: The same day after operation and 3 d after operation, serum HMGB-1, IL-2, IL-6, hs-CRP, ET-1, ACTH, Cor and MDA levels as well as peripheral blood CD8+ levels of observation group were significantly lower than those of control group while serum SOD, IgG, IgM and IgA levels as well as peripheral blood CD3+ and CD4+ levels were significantly higher than those of control group. Conclusion: Percutaneous transhepatic gallbladder puncture combined with laparoscopic surgery for acute severe cholecystitis can improve the postoperative inflammatory response, stress response and immune response.