关键词: 免气腹腹腔镜, 胆道探查, 凝血, 纤维蛋白溶解, 胆石症

Abstract: Objective To investigate the influence on the coagulation function in the patients undergone gasless laparoscopic bile duct exploration.Methods Twenty-six patients undergone gasless laparoscopic common bile duct exploration were enrolled into this research. Blood samples were collected before, during and after the abdominal wall suspension, as well as the first day after operation. The following plasma molecular markers were measured:tissue-type plasminogen activator (t-PA), thrombin-antithrombin Ⅲ complexes (TAT), tissue factor activity (TF:A) and plasminogen activator inhibitor-1 (PAI-1). Results ① TF:A was significantly increased among the four groups (P<0.01). Bonferroni post hoc test indicated that TF:A of the post-suspension group was significantly increased compared to the pre-suspension group, mid-suspension group and post-operation group, respectively (P<0.01). ② TAT was not increased significantly among the four groups (P>0.05). ③ t-PA was significantly increased among the four groups (P<0.01). Bonferroni post hoc test indicated t-PA of the post-suspension group was significantly increased compared to the pre-suspension group and mid-suspension group (P<0.01). And t-PA of the post-operation group was significantly increased compared to the pre-suspension group and mid-suspension group (P<0.01). ④ PAI-1 was significantly increased among the four groups (P<0.01). Post hoc multiple comparison indicated that PAI-1 of the post-suspension group was significantly increased compared to the pre-suspension group, mid-suspension group and post-operation group, respectively (P<0.01).Conclusion Gasless laparoscopic common bile duct exploration activated the coagulation function within the controllable range of the body, and did not lead to hypercoagulation state after operation.

Key words: gasless laparoscopy, common bile duct exploration, coagulation, fibrinolysis, cholelithiasis