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ISSN 1001-5256 (Print)
ISSN 2097-3497 (Online)
CN 22-1108/R
Volume 39 Issue 10
Oct.  2023
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Article Contents

Clinical effect of Qingre Lidan granules in preventing the recurrence of choledocholithiasis after laparoscopy combined with choledochoscopy

DOI: 10.3969/j.issn.1001-5256.2023.10.020
Research funding:

National Natural Science Foundation of China (82174136);

Key Clinical Specialty Capacity Building Project of TCM of LiaoNing Provincial Health Commission (LiaoNing Health Office 2019(169))

More Information
  • Corresponding author: ZHANG Guixin, zgx@126.com (ORCID: 0000-0002-6171-394X)
  • Received Date: 2023-02-06
  • Published Date: 2023-10-30
  •   Objective  To investigate the effect of Qingre Lidan granules in preventing the recurrence of choledocholithiasis after laparoscopy combined with choledochoscopy through a retrospective cohort study.  Methods  A total of 337 inpatients with choledocholithiasis (including those with cholecystolithiasis at the same time) who underwent laparoscopy combined with choledochoscopic lithotomy in The First Affiliated Hospital of Dalian Medical University from January 1, 2010 to December 31, 2020 were enrolled, and related clinical data were collected. According to the follow-up results, the patients were divided into exposure group (conventional treatment+Qingre Lidan granules) with 225 patients and non-exposure group (conventional treatment) with 112 patients. The recurrence of choledocholithiasis and the administration of Qingre Lidan granules were recorded in detail for both groups. The recurrence rate of choledocholithiasis and the time to recurrence were observed for both groups, and the risk factors for the recurrence of choledocholithiasis were analyzed. The independent-samples t test was used for comparison of normally distributed continuous data between two groups, and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups; the chi-square test or the Fisher’s exact test was used for comparison of categorical data between two groups. The Kaplan-Meier curve was used to estimate the cumulative probability of choledocholithiasis recurrence in the two groups, and the Log-rank test was used for comparison between two groups.  Results  A total of 26 patients experienced the recurrence of choledocholithiasis after laparoscopy combined with choledochoscopy, with 12 patients (5.33%) in the exposure group and 14 (12.5%) in the non-exposure group, and the exposure group had a significantly lower recurrence rate than the non-exposure group (χ2=5.394, P=0.020). The exposure group had a significantly longer mean time to the recurrence of choledocholithiasis than the non-exposure group (40.1±26.7 months vs 19.2±13.5 months, t=2.383, P=0.017). The Kaplan-Meier curve analysis showed that the non-exposure group had a significantly higher cumulative recurrence rate than the exposure group in different periods of time (P<0.05). The multivariate logistic regression analysis showed that common bile duct diameter ≥14 mm (odds ratio 〔OR〕=2.935, P=0.031) and multiple calculi (OR=2.911, P=0.029) were independent risk factors for the recurrence of choledocholithiasis after laparoscopy combined with choledochoscopic lithotomy.  Conclusion  Qingre Lidan granules can effectively reduce the recurrence rate of choledocholithiasis and prolong the time to the recurrence of choledocholithiasis after laparoscopy combined with choledochoscopy and has a certain clinical effect in preventing the recurrence of choledocholithiasis after surgery.

     

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