Efficacy of Chaiqin Lidan formula combined with ursodeoxycholic acid in patients with high-risk recurrent choledocholithiasis after primary closure following choledochotomy
XIN Hai-bei,BAI Bin,SU Xian
Department of Hepatobiliary Surgery, Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai201899, China
Abstract:
Objective To investigate the clinical efficacy of Chaiqin Lidan formula combined with ursodeoxycholic acid capsules in patients at high risk of recurrence after primary closure following choledochotomy for common bile duct stones, and to explore its role in promoting postoperative recovery and reducing the risk of stone recurrence. Methods A prospective controlled study was conducted involving 120 patients with common bile duct stones at high risk of recurrence who underwent primary closure following choledochotomy in the Department of Hepatobiliary Surgery, Shanghai Municipal Hospital of Traditional Chinese Medicine, between June 2023 and June 2025. The patients were randomly assigned to a combination group and a control group, with 60 patients in each group. The control group received ursodeoxycholic acid capsules postoperatively, while the combination group was additionally treated with Chaiqin Lidan formula. Postoperative liver function indices [alanine aminotransferase (ALT), aspartate aminotransferase (AST), and total bilirubin (TBil)], time to improvement of clinical symptoms, incidence of postoperative complications, and stone recurrence during the follow-up period were compared between the two groups. Results On postoperative day 7, levels of ALT, AST, and TBil in the combination group were significantly lower than those in the control group (P <0.001). The difference in the time to improvement of clinical symptoms between the two groups was not statistically significant (P > 0.05). The incidence of postoperative complications was 5.0% in the combination group, which was lower than 11.7% in the control group; however, the difference was not statistically significant (P =0.186). During the 6-month follow-up period, the stone recurrence rate was 3.3% in the combination group and 8.3% in the control group, with no statistically significant difference between the groups (P =0.436). Conclusion Chaiqin Lidan formula combined with ursodeoxycholic acid can effectively improve liver function in patients at high risk of recurrence after primary closure following choledochotomy. The combination therapy may reduce postoperative complications and short-term stone recurrence.
