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External application of mirabilite before surgery can reduce the inflammatory response and accelerate recovery in
Hao Cai1,2, Jian Du2, Cheng Luo2
1Department of Hepatobiliary Surgery, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, 400010, China.
Objective:
Mild acute biliary pancreatitis (MABP) is one of the most common diseases that require surgical treatment. Previous studies have focused on the timing of laparoscopic cholecystectomy (LC) for MABP. However, the impact of its inflammatory response process on the clinical outcome has been rarely reported. This study aimed to investigate the effect of preoperative external application of mirabilite on the inflammatory response and clinical efficacy in MABP.
Methods:
Medical records of patients undergoing LC due to MABP from November 2017 to June 2022 were retrospectively reviewed. Prior to surgery, the control group received the same baseline treatment measures as the study group. The difference was the addition of external application of mirabilite in the study group.
Results:
A total of 75 patients were included in the final analysis: 38 patients in the mirabilite group and 37 patients in the control group. Repeated-measures ANOVA (P < 0.01) showed that the white blood cell count (WBC) on the 3rd day of admission and the WBC and C-reactive protein (CRP) level on the 5th day of admission decreased rapidly and significantly in the mirabilite group, compared with the control group. The mirabilite group had earlier anal exhaust time. The number of patients in the mirabilite group and control group with gallbladder wall ≥ 3 mm before the operation was 16 (42.11%) vs. 24 (64.86%), p = 0.048, respectively; and the number of cases with surgical drain placement was 2 (5.26%) vs. 9 (24.32%), p = 0.020, respectively. The intraoperative modified American Fertility Society (mAFS) score of adhesions was lower in the mirabilite group (1.08 ± 0.59 points) than in the control group (1.92 ± 0.60 points), p = 0.000. The mirabilite group, compared to the control group, p = 0.000, had a short waiting time for surgery (5.68 ± 0.70 days vs. 6.54 ± 0.59 days), short operation time (38.03 ± 5.90 min vs. 48.51 ± 8.37 min), and reduced hospitalization time (8.95 ± 0.96 days vs. 9.84 ± 1.07 days).
Conclusion:
This study demonstrated that preoperative external application of mirabilite can reduce the inflammatory response, decrease the edema and peribiliary adhesions at the surgical site, and accelerate recovery in MABP.
Insights
Preoperative external application of mirabilite significantly reduced inflammatory markers and improved clinical outcomes in patients with mild acute biliary pancreatitis (MABP). This treatment accelerated recovery and decreased surgical complications, offering a promising approach for MABP management.
Area of Science:
- Gastroenterology and Hepatology
- Surgical Innovation
- Inflammatory Response Modulation
Background:
- Mild acute biliary pancreatitis (MABP) is a common condition requiring surgical intervention, typically laparoscopic cholecystectomy (LC).
- The impact of inflammatory processes on clinical outcomes in MABP, particularly concerning preoperative interventions, remains underexplored.
- Understanding and mitigating the inflammatory response is crucial for optimizing surgical outcomes in MABP patients.
Purpose of the Study:
- To investigate the effect of preoperative external mirabilite application on the inflammatory response in MABP patients.
- To evaluate the clinical efficacy of mirabilite in improving surgical outcomes for MABP.
- To assess mirabilite's impact on reducing edema and adhesions at the surgical site.
Main Methods:
- Retrospective review of medical records for 75 patients undergoing LC for MABP (November 2017 - June 2022).
- Patients were divided into a mirabilite group (external mirabilite application pre-surgery) and a control group.
- Comparison of inflammatory markers (WBC, CRP), surgical parameters, and recovery times between the two groups.
Main Results:
- The mirabilite group showed significantly reduced white blood cell (WBC) and C-reactive protein (CRP) levels on days 3 and 5 post-admission.
- Earlier anal exhaust time, reduced incidence of gallbladder wall thickening (≥3 mm), and fewer surgical drain placements were observed in the mirabilite group.
- Lower intraoperative adhesion scores (mAFS), shorter waiting times for surgery, reduced operation times, and shorter hospitalization periods were noted with mirabilite use.
Conclusions:
- Preoperative external mirabilite application effectively reduces the inflammatory response in MABP patients.
- Mirabilite application decreases surgical site edema and peribiliary adhesions, contributing to improved clinical efficacy.
- This intervention accelerates patient recovery, suggesting a beneficial role in managing MABP.
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