Clinical efficacy of duodenoscopy combined with laparoscopy in the treatment of patients with severe acute pancreatitis and pancreatic pseudocyst, and the effects on IL‑6 and CRP

Abstract

The study aimed to investigate the clinical efficacy of duodenoscopy combined with laparoscopy in the treatment of patients with severe acute pancreatitis (SAP) and pancreatic pseudocyst (PP), and its effects on serum inflammatory factors. Altogether 94 patients complicated with SAP and PP who were admitted to Weifang People's Hospital (Weifang, China) from September 2015 to December 2018 were included. Based on the different operation methods, 49 patients who underwent traditional laparotomy under laparoscopic surgery were included in group A, and 45 patients who underwent duodenoscopy and laparoscopy under duodenoscope to treat the drainage of nipple and pancreatic pseudocysts were included in group B. The expression levels of related serum indexes and serum stress indexes before and at 48 h after surgery, the postoperative nausea, vomiting and abdominal pain scores, as well as the clinical efficacy, perioperative related indexes, recovery and complications were compared between the two groups. The prognostic factors in both groups were assessed via Logistic univariate and multivariate analyses. C-reactive protein (CRP), tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), interleukin-β (IL-β), endotoxin and nuclear factor κB (NF-κB) were significantly lower in group B than those in group A (P<0.001). Upregulating cortisol and norepinephrine in group B was lower than that in group A (P<0.001). The total effective rate in group B was higher than that in group A (P<0.05). The perioperative related indexes, recovery, and postoperative complications in group B were better than those in group A (P<0.05). Scores of abdominal pain, nausea and vomiting in group B were markedly lower than those in group A (P<0.001). Multivariate Logistic regression analysis showed that CRP, TNF-α, IL-6, IL-β and surgical methods were independent risk factors for the prognosis of patients with SAP and PP. In conclusion, the combined treatment with duodenoscopy and laparoscopic surgery has little inflammatory and stress reaction, and it is highly safe, worthy to be popularized.

Artificial Intelligence‐Assisted Visual Sensing Technology under Duodenoscopy of Gallbladder Stones

“…What is more, the therapeutic effect of the biliary function index of the AI group was also much better than that of the conventional group. The above results are consistent with most other complication rates after treatment with laparoscopy combined with duodenoscope for treatment of gallbladder stones combined with common bile duct stones [4,5,[26][27][28], providing support for laparoscopy combined with duodenoscope in the treatment of gallstones. Of course, AI-assisted visual sensing technology shows a wide range of applications, not just for assisted endoscopic treatment of gallbladder stones, which has been illustrated in a number of studies on the optimization of colonoscopy bowel preparation and the establishment and preliminary verification of the artificial intelligence-assisted colorectal polyp identification system [29][30][31][32].…”

“…According to the above definitions, the higher the precision (that was, the ratio of the predicted correct pixel to the predicted total pixel), the higher the FP was (the fewer false predictions). The precision can be calculated with equation (28). The higher the recall (the ratio of the predicted correct pixel to the true value pixel) was, the less FN was, which meant the less missed detection of segmentation result.…”