The Effect Of Oxygen Replacement Of Carbon Dioxide On Abdominal Anaerobic Infection After The Laparoscopic Bile Duct Exploration And Removing The Stone

Objective: To understand the effect of anaerobic bacteria intra-abdominal infection when using the oxygen replacement of intra-abdominal residual carbon dioxide which can set up partial high oxygen environment within the abdominal cavity in patients with common bile duct stones and has performed the operation,And preliminary discussion on its significance.Methods: There were 68 patients suffering from Bile duct stones and acute cholangitis in the department of hepatobiliary surgery of the Second People’s Hospital of Chengdu which is Zun Yi Medical College affiliated hospital From June 2015 to December 2017.Then randomly divided them into two groups by the EXCEL software,including 34 cases of the control group and 34 cases of experimental group.The control group uses LC+LCBDE+TD,and uses CO₂ to replace intra-abdominal CO₂ with three times.The experimental group uses LC+LCBDE+TD,after surgery,using O₂ to replace intra-abdominal CO₂ with three times to make sure that the experimental group can finish surgery with high concentration of oxygen in their enterocoelia.Record the following information : preoperative general situation: gender,age;preoperative infection index: WBC,PCT,CRP;preoperative liver function index: ALT,AST,TBIL,DBIL.Record the results of the bile anaerobic bacteria culture in the surgery with “positive” or “negative”.Record the results of the bile anaerobic bacteria culture from the T tube at the first day and third day after surgery respectively with“positive” or “negative”.Record the results of the ascites anaerobic bacteria culture from the drainage tube at the first day and third day after surgery respectively with“positive” or “negative”.Record the infection index（WBC,PCT and CRP）and liver function index（ALT,AST,TBIL,DBIL）at the first day and third day after surgery.Then do a statistical analysis.Results: 1.The control group and experimental group is no statistical difference in sexand age（P>0.05）.2.The control group and experimental group of liver function index（ALT,AST,TBIL,DBIL）at the day before operation,The difference between the day before operation and the day after operation,the difference between the day after operation and 3 days after operation,The difference between the day before operation and 3days after operation,were no statistically significant difference（P > 0.05）.3.The control group and experimental group of preoperative white blood cell count,and the difference between the day before operation and the day after operation,the difference between the day after operation and 3 days after operation,the difference between the day before operation and 3 days after operation were no statistical difference（P>0.05）.4.The control group and experimental group of preoperative procalcitonin is no statistical difference（P>0.05）,the difference of procalcitonin about control group and experimental group in the difference between the day before operation and the day after operation,and difference between the day after operation and 3 days after operation and the difference between the day before operation and 3 days after operation is statistically significant（P<0.05）.The rate of descent of experimental group are more than the control group in day after surgery and the third day after operation.5.The difference between Control group and experimental group in c-reactive protein at the day before operation and the difference of the day before operation and the day after surgery were no statistical difference（P>0.05）.The C-reactive protein of Control group and experimental group were difference between the day before operation and the day after operation,the day before operation and 3 days after operation and the difference were statistically significant（P<0.05）,the C-reactive protein of experimental group was falling more than the control group.6.The difference of Bile anaerobic bacteria culture between Control group and experimental group in the surgery were no statistical differences（P>0.05）;Get the bile from T tube and cultured anaerobic bacteria at the day after operation and 3 days after operation,the result were no statistical differences（P>0.05）;Get the ascites from Abdominal cavity drainage tube and cultured anaerobic bacteria at the day after operation and 3 days after operation,the result were statistical differences（P>0.05）,the positive rate of experimental group were significantly lower than the control group.Conclusion: 1.After surgery,using oxygen to replace CO₂ pneumoperitoneum to provide local high oxygen environment which can reduce positive rate of anaero bic bacteria culture of ascites which from abdominal cavity drainage tube.2.As the safety pneumoperitoneum gas,Oxygen can make the postoperative inflammation index decreased when it replaced CO₂ in abdominal cavity.3.In the assessment of infection after Choledochotomy,procalcitonin is more sensitive than WBC and CRP in the biliary calculus.