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Objective:To investigate the clinical advantages of absorbable barbed wires in laparoscopy combined with choledochoscopy treatment of gallbladder polyps.Methods:The clinical data of 103 patients with gallbladder polyps who received laparoscopy combined with choledochoscopy treatment in The First People's Hospital of Lianyungang from February 2016 to March 2018 were retrospectively analyzed. Sixty-five patients in the observation group underwent gallbladder wall sutures with absorbable barbed wires, and thirty-eight patients in the control group underwent gallbladder wall sutures with common absorbable wires. The operative time, gallbladder wall suture time, intraoperative blood loss, average hospitalization time, and postoperative bile leakage were compared between the two groups.Results:There were no significant differences in intraoperative blood loss and average hospitalization time between the two groups ( P = 0.312, P = 0.114). In the observation group, gallbladder wall suture time and operative time were (5.58 ± 1.14) minutes and (60.71 ± 11.03) minutes, respectively, which were shorter than (6.32 ± 1.04) minutes and (68.24 ± 9.61) minutes in the control group ( t = 3.23, 3.50, P = 0.002, 0.001). No bile leakage occurred in the observation group and bile leakage occurred in four (10.5%) patients in the control group. There was a significant difference in bile leakage between the observation and control groups ( χ2 = 4.57, P = 0.032). Conclusion:Absorbable barbed wires for gallbladder wall sutures during operation in laparoscopy combined with choledochoscopy treatment of gallbladder polyps is safe and feasible. It can markedly shorten gallbladder wall suture time and operative time, decrease the incidence of bile leakage, and has a clinical advantage over common absorbable wires.
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Objective:To compare the therapeutic effect of one-stage versus two-stage percutaneous transhepatic biliary fistulation lithotripsy in treatment of complex hepatolithiasis.Methods:A retrospective study was conducted on 145 patients with complex hepatolithiasis who were treated at the First Affiliated Hospital of Guangzhou Medical University between September 2013 and June 2018. There were 60 males and 85 females, aged 21 to 91 (56.5±14.1) years. According to the method of fistula establishment, patients were divided into the percutaneous transhepatic one-step biliary fistulation (PTOBF) group ( n=94) or the two-stage percutaneous transhepatic choledochoscopic lithotripsy (PTCSL) group ( n=51). The success rates of one-time puncture and fistula dilation, operation time of lithotripsy, operative conversion rate (PTCSL was converted to laparotomy and laparoscopic surgery), postoperative complications (including catheter dislodgement), residual stone rates and stone recurrence rates were compared between groups. Results:In the PTOBF group, operation time (105.8±43.6) min, success rate of one puncture 73.4% (69/94), and success rate of one fistula dilation 93.6% (88/94), the rate of operative conversion 0. All these results were significantly better than the corresponding results of the two-stage PTCSL group of (130.0±70.0) min, 54.9% (28/51), 68.6% (35/51), and 13.7%(7/51) respectively (all P<0.05). There were no significant differences in stone residual rate [17.0%(16/94) vs. 15.7% (8/51)] and stone recurrence rate [14.9%(14/94) vs. 17.6% (9/51)] between groups (both P>0.05). The postoperative complications rate was 7.4%(7/94) in PTOBF group, which was 39.2% (20/51) in two-stage PTCSL group (χ 2=22.02, P<0.001). The catheter dislodgement rate of PTOBF group was 2.1% (2/94), lower than that of two-stage PTCSL group 27.4% (14/51), the difference was statistically significant (χ 2=21.59, P<0.001). Conclusion:One-stage PTOBF and two-stage PTCSL were both safe and effective in treatment of complex hepatolithiasis. However, PTOBF had shorter operative times, lower catheter dislodgement and operative conversion rates than PTCSL.
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Objective To study the advantages of laparoscopic primary suturing of common bile duct plus transabdominal nasobiliary drainage in reducing the rate of bile leakage.Methods The clinical data of laparoscopic primary suturing of common bile duct with or without nasal bile duct drainage in Second People's Hospital of Chengdu were analyzed retrospectively.Results During laparoscopic common bile duct exploration,286 patients were treated by primary suturing without nasobiliary drainage (group without drainage),including 32 (11.2％) patients with bile leakage;350 patients were treated by primary suturing with transabdominal nasobihary drainage (group with drainage),including 11 (3.1％) patients with bile leakage.The incidences of bile leakage of the two groups were significantly different (P ＜ 0.05).When the diameter of the common bile duct was less than 11.0 mm,the incidence of bile leakage in the non-drainage group and the drainage group were 18.5％ (20/108) and 2.1％ (3/143),respectively.The incidence in the drainage group was significantly lower than that in the non-drainage group,and the difference was statistically significant (P ＜ 0.05).When the diameter of common bile duct was larger than 11.0 mm,there was no significant difference in the incidences of bile leakage between the two groups (P ＞ 0.05).Conclusions The choice after laparoscopic primary suturing of common bile duct between with or without nasobiliary drainage should be determined according to the diameter of common bile duct.When a common bile duct diameter of less than 11.0 mm,nasobiliary drainage is recommended to reduce the rate of bile leakage.
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Complicated extrahepatic bile duct stone is defined as not easy to achieve the treatment standard of total stone clearance, stricture removal, unobstructed drainage and recurrence preventing in a single operation or combined with other liver diseases, which include hepatic hilar bile duct stones incarceration, distal bile duct stone incarceration, Mirizzi syndrome, residual cystic duct stones, recurrent extrahepatic bile duct stones, and combined with portal hypertension or intrahepatic bile duct stones. Through comprehensive and meticulous preoperative evaluation, we can clarify the cause of extrahepatic bile duct stones, the location of stones and bile duct stenosis, the variability of bile duct, the anatomy of the hepatoduodenal ligament, the condition of liver function and biliary tract infection, and make the proper surgery plan. During the surgery, we apply the perihilar surgical techniques, pancreatic hilar plate reduction techniques, Oddi sphincter incision and shaping, and choledochoscopic lithotripsy and lithotomy comprehensively to achieve the goal of reducing residual stone rate and recurrence rate. It is important that reasonably select endoscopic retrograde cholangiopancreatography indications, correctly hold indications of bilioenteric anastomosis, and prevent iatrogenic injury of extrahepatic bile ducts on the premise of clearing stones.
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Objective@#To study the clinical outcomes of anatomical hepatectomy combined with intraoperative choledochoscopy in treatment of complicated hepatolithiasis.@*Methods@#The clinical data of 176 patients with complicated hepatolithiasis who underwent operation at the Department of General Surgery of No.960 Hospital of PLA from May 2005 to July 2015 were analyzed retrospectively. The data included general data, clinical manifestations, types of stones, operative methods, postoperative complications and follow-up.@*Results@#There was no perioperative death. The postoperative complications which occurred in 31 patients (17.6%) included lung infection, intra-abdominal infection, bile leakage, and liver failure. Eighteen patients (10.2%) were found to have residual stones. After a follow-up which ranged from 1 to 3 years, 152 patients (94.4%) had good clinical outcomes. Recurrent stones were found in 12 patients (7.5%).@*Conclusion@#Anatomical hepatectomy combined with intraoperative choledochoscopy improved operative outcomes in patients with complicated hepatolithiasis and decreased residual stone and recurrence rates.
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Objective To study the clinical outcomes of anatomical hepatectomy combined withintraoperative choledochoscopy in treatment of complicated hepatolithiasis.Methods The clinical data of176 patients with complicated hepatolithiasis who underwent operation at the Department of General Surgeryof No.960 Hospital of PLA from May 2005 to July 2015 were analyzed retrospectively.The data includedgeneral data,clinical manifestations,types of stones,operative methods,postoperative complications andfollow-up.Results There was no perioperative death.The postoperative complications which occurred in 31patients (17.6％) included lung infection,intra-abdominal infection,bile leakage,and liver failure.Eighteen patients (10.2％) were found to have residual stones.After a follow-up which ranged from 1 to 3years,152 patients (94.4％) had good clinical outcomes.Recurrent stones were found in 12 patients(7.5％).Conclusion Anatomical hepatectomy combined with intraoperative choledochoscopy improvedoperative outcomes in patients with complicated hepatolithiasis and decreased residual stone and recurrencerates.
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OBJECTIVE: To explore therapeutic strategies of type Ⅲa hepatolithiasis. METHODS: The clinical data of 86 patients with type Ⅲ a hepatolithiasis admitted from July 2014 to December 2017 in Department of Hepatobiliary Surgery, the First Affiliated Hospital of Guangxi University of Chinese Medicine were retrospectively analyzed. Patients without liver resection were included. Variables including residual stones,times of choledochoscopy performing,stone clearance rate and recurrence rate were observed. RESULTS: There was a total of 23 patients with biliary strictures and 2 cases of bile leakage after operation,83 patients(96.5%) residual stones after Initial treatment. About six weeks after surgery,the choledochoscopy was performed via T tube sinus or subcutaneous blind loop. The median lithotomy times was 3. There were 4 cases of residual small stones,and stone clearance rate was 95.4%. Median follow-up time was 24 months. 6 patients(7.0%) had recurrent intrahepatic bile duct stones,and the proficiency was 93.0%(80/86). 6 patients(7.0%) had sporadic cholangitis. CONCLUSION: It is safe and feasible to correct the stricture and remove the stones through the combination of biliary surgery and choledochoscope for type Ⅲa hepatolithiasis. The short-term outcomes are satisfactory.
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Complicated extrahepatic bile duct stone is defined as not easy to achieve the treatment standard of total stone clearance,stricture removal,unobstructed drainage and recurrence preventing in a single operation or combined with other liver diseases,which include hepatic hilar bile duct stones incarceration,distal bile duct stone incarceration,Mirizzi syndrome,residual cystic duct stones,recurrent extrahepatic bile duct stones,and combined with portal hypertension or intrahepatic bile duct stones.Through comprehensive and meticulous preoperative evaluation,we can clarify the cause of extrahepatic bile duct stones,the location of stones and bile duct stenosis,the variability of bile duct,the anatomy of the hepatoduodenal ligament,the condition of liver function and biliary tract infection,and make the proper surgery plan.During the surgery,we apply the perihilar surgical techniques,pancreatic hilar plate reduction techniques,Oddi sphincter incision and shaping,and choledochoscopic lithotripsy and lithotomy comprehensively to achieve the goal of reducing residual stone rate and recurrence rate.It is important that reasonably select endoscopic retrograde cholangiopancreatography indications,correctly hold indications of bilioenteric anastomosis,and prevent iatrogenic injury of extrahepatic bile ducts on the premise of clearing stones.
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Objective To analyze our experience in laparoscopic common bile duct ( CBD) explo-ration using a 5 mm choledochoscope through a micro-incision at the junction between the cystic duct and the CBD for patients with choledocholithiasis and cholecystolithiasis. Methods From January 2014 to May 2018, laparoscopic common bile duct exploration through a micro-incision at the cystic duct-CBD junction was performed in 77 patients with choledocholithiasis and cholecystolithiasis at Beijing Tongren Hospital, Capital Medical University. Results Laparoscopic common bile duct exploration was performed successfully through a micro-incision in 77 patients with primary suturing of the micro-incision. The range of operation time, blood loss, and hospital stay were 65～150 min, 10～50 ml, and 4～9 d respectively. Seven patients developed minor bile leakage postoperatively and were treated successfully after 3 ～7 days of conservative treatment. Conclusion Common bile duct laparoscopic exploration using a choledochoscope for choledocho-lithiasis and cholecystolithiasis through a micro-incision at the junction of cystic duct and CBD was a safe and effective method.
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Objective To analyze and compare the postoperative complications and perioperative data of laparotomy surgery and combined laparoscopy and choledochoscopy surgery for non-severe acute cholangitis.Methods Retrospective analyzed the clinical data of 134 patients,with non-severe acute cholangitis at First Affiliated Hospital of He'nan University from June 2015 to May 2017.The patients were divided into combined group (76 cases) and traditional group (58 cases) according to operation mode,and the postoperative complications and perioperative data including amount of bleeding,postoperative exhaust time,operative time,incision length,length of stay and extubation time of T-tube were compared.The measurement data were expressed by (-x ± s),and the t test was used between the groups.Comparison of count data were analyzed using the chi-square test.Results The amount of bleeding,postoperative exhaust time,incision length and length of stay were respectively (48.90 ± 16.23) ml,(1.94 ± 0.45) d,(4.53 ±1.97) cm,(7.81 ±2.23) d in the combined group and were significantly less than those in the traditional group (98.53 ± 17.34) ml,(2.42 ± 0.56) d,(8.34 ± 2.05) cm,(12.27 ± 1.56) d,with statistically significant diffbrences between the two groups (t =7.173,8.242,12.847,8.242;P =0.000,0.000,0.004,0.021).The operative time of the combined group was (157.75 ± 17.34) min,and that of the traditional group was (138.43 ±23.84) min,but there was no significant difference between the two groups (t =13.661,P =0.069).The extubation time of T-tube in the combined group and the traditional group was (29.78 ± 1.54) d and (22.54 ± 0.96) d,respectively.The differences between the two groups were statistically significant (t =3.435,P =0.043).Postoperative complications occurred in 16 out of all 134 patients,and bile leakage,residual stones and incision infection were the top three complications.The incidence of postoperative complications in the combined group and the traditional group was 5.26％ (4/76)and 20.69％ (12/58),respectively.The differences between the two groups were statistically significant (x2 =7.445,P =0.006).Conclusion The incidence of complications of calculous non-severe acute cholangitis combined laparoscopy and choledochoscopy is lower than traditional surgical operations,and more conforms to the enhanced recovery after surgery,and the postoperative recovery is faster than that of the traditional group.
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Objective To explore the clinical application of laparoscopic transcystic common bile duct exploration.Methods From Jan 2014 to Dec 2015,laparoscopic transcystic common bile duct exploration was performed in 52 cases of cholecystolithiasis.The therapeutic effects of cases were studied.Results Among them,40 cases were performed operation successfully.The success rate of operation was 76.92％.7 cases were changed to laparoscopic common bile duct incision exploratory stone operation.5 cases were performed common bile duct incision nephrolithotomy,and the transfer rate was 9.62％.43 cases were toke stone success at a time in all of patients.The success removed rate was 82.69％.The last 9 patients included 8 cases performed laparoscopic transcystic common bile duct exploration and 1 case performed laparoscopic common bile duct incision exploratory stone operation.All cases were placed abdominal cavity drainage tube pulled out after 3-10 days.Biliary leakage occurred in 1 patients performed laparoscopic common bile duct incision exploratory stone operation,and it was cured after conservative treatment.No biliary tract infection,biliary tract bleeding complications occurred.The average hospitalization time was (8.24 ± 2.52) days.All patients were followed up 1 year.No extrahepatic bile duct stones were found by B-ultrasonic and MRCP,and bilirubin were normal.Conclusion Laparoscopic transcystic common bile duct exploration has positive clinical efficacy with small trauma,quick rever,less complications,safety and etfective.etc.But its indications must be grasped strictly in clinical promotion.
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Objective:The application of a combined ultrasound and pneumatic lithotripter for cholelithiasis was investigated.Methods:A total of 59 cases of cholelithiasis diagnosed by ultrasonography and CT were included in the study.All the patients had surgical treatment from January 2013 to December 2015,in which 30 patients were treated with a combined ultrasound and pneumatic lithotripter protocol (EMS group),and 29 patients were treated with traditional choledochoscope protocol(control group).All the patients were followed up for 3 months postoperation.The outcomes of patients in EMS group and control group were compared.Results:The postoperative stone free rate after the first operation is higher in EMS group than in control group(P＜0.05).The operation time and total lengths of hospital stay were shorter in EMS group than in control group(P＜0.05).There was no significant difference in intraoperative hematobilia rate,intraoperative bile duct injury rate,postoperative biliary tract infection rate,hepatic biochemical index and mortality between two groups(P＞0.05).Conclusion:The combined ultrasound and pneumatic lithotripter is useful for treatment of cholelithiasis.
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Objective To study the diagnosis,treatment and therapeutic results of 11 patients who suffered from mucinous tumor of the bile duct.Methods Eleven patients who were diagnosed to suffer from mucinous tumor of the bile duct were retrospectively studied.Three patients who presented with obstructive jaundice were diagnosed on ERCP,and 8 patients who had extra-and intrahepatic cholangiolithiasis were diagnosed by biopsy during choledochoscopy.Results One of the 3 patients who underwent ERCP died from obstructive jaundice after failed drainage of bile using endoscopic nasobiliary drainage (ENBD).The remaining two patients underwent laparoscopic common bile duct exploration and T tube drainage.The eight patients who had extra-and intrahepatic cholangiolithiasis were diagnosed by biopsy during choledochoscopy.Conclusions The clinical presentation of mucinous tumor of bile duct is non-specific and the preoperative misdiagnosis rate is high.Common bile duct exploration,T tube drainage and long-term T tube drainage is a good way to treat mucinous tumor of the bile duct.
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The clinical data of 143 patients with type Ⅱ a hepatolithiasis with normal function of the sphincter of Oddi were analyzed.The patients were divided into two groups at random.The data of the 2 groups of patients were compared on the operating time,hospitalization,rates of complication,residual stone rates and recurrence rates.The A group patients underwent laparoscopic video choledochoscopic hepaticocholangiolithotomy,T-tube drainage and choledochoscopic lithotomy.The B group patients underwent laparoscopic video hepatectomy and choledochoscopic lithotomy.For most of the patients in the A group,the treatment had the advantages of less trauma,less complications and quicker recovery.There was no significant differences in residual stone rates and recurrence rates between the two groups.As it was difficult to remove stones in the caudate lobes of Ⅱ a type patients in A group due to the sharp angle between the hepatic duct and bile ducts of the caudate lobe,individualized programs should be adopted according to the location of stones on individual patients.
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The clinical data of 7 patients who underwent the treatment of gradual and persistent balloon dilatation (GPBD) by percutaneous transhepatic cholangiography (PTC)for traumatic biliary stricture in Zhongshan Hospital Affiliated to Dalian University were analyzed retrospectively.Balloon catheters were successfully implanted in 5 cases by PTC,and with the help of ERCP in 2 PTC failed cases.There was no bleeding,acute pancreatitis and other complications.Two balloon catheters were damaged and displaced,respectively.All the biliary strictures were relieved.No biliary sludge was attached on the surface of the balloon and in the bile duct.Bile duct mucosa had congestion edema and cellulose attachment.There was no biliary stricture recurrence in the follow-up of 5 to 27 months.This study showed GPBD by PTC was a simple,safe and effective method for treating traumatic biliary strictures.
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Objective To explore the feasibility of electromagnetic navigation for hepatic ducts exploration by choledochoscope based on a three-dimensional (3D) printing model.Methods The retrospective descriptive study was conducted.The clinical data of 1 patient with obstructive jaundice combined with secondary biliary tract dilation who was admitted to the Beijing Tsinghua Changgung Hospital in April 2016 were collected.Digital imaging and standardized format data of enhanced computed tomography (CT) scan were collected,3D reconstruction of liver and bile duct were done under a 3D printing model,and then a hollow model of bile duct was achieved.Choledochoscope with internal electromagnetic probe was inserted into the printed hepatic ducts.Four points of anatomical markers in left and right hepatic ducts and common hepatic duct were chosen as fiducial markers for calibration and registration.Results After registration,the scope can be tracked in main hepatic segmental bile ducts.The locations of choledochoscope matched precisely the navigation results.Conclusion Electromagnetic navigation may bring accurate tracking effectiveness for choledochoscopic examination.
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Objective:To observe the surgical effects of laparoscopy and choledochoscope combination in the treatment of common bile duct stones and the complications occurrence situation,so as to provide reference for the clinical surgical treatment for common bile duct stones.Methods:The clinical materials of 120 common bile duct stones received surgical treatment in the Hepatobiliary Surgery of our hospital from January 2013 to January 2015 were retrospectively analyzed,and were divided into two groups according to the surgical approaches.The control group were given conventional open cholecystectomy,and the research group were given laparoscopy and choledochoscope combination surgery.The surgical situations and complications in these two groups were observed.Results:The surgical time in the research group was significantly longer than in the control group (P＜0.05),the blood loss,gastrointestinal recovery time,ambulation time,hospital stay were significantly shorter than in the control group (P＜0.05);the complication incidence such as pain,infection,bile leakage,residual stone in the research group was 8.3％,significantly lower than 21.7％ in the control group (P＜0.05).Conclusion:The combination treatment of laparoscopy and choledochoscope in the common bile duct stones has good curative effects,less blood loss,rapid recovery,and less impact on the gastrointestinal function,low incidence of complications,and can significantly shorten the length of hospital stay,can be used as the first choice in clinical practice.
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Objective To compare using the transabdominal route versus the transoral route in establishing naso-biliary drainage in laparoscopic surgery.Methods The combined use of laparoscopy with choledochoscopy and duodenoscopy to establish naso-biliary drainage was carried out in 204 patients with gallbladder and common bile duct calculi.In 162 patients,the naso-biliary drainage was established transabdominally and in 42 patients it was established transorally.The success and the complication rates in the two groups were compared.Results Of 162 patients using the transabdominal route,4 patients failed.There were 6 patients (3.7％) who had no output from the nasobiliary drain.There were 3 patients (1.8％) who had only intestinal juice outflow from the nasobiliary drain.Primary closure failed in 3 patients (1.8％),all resulting in bile leak.Pancreatitis occurred in 2 patients (1.2％) after the operation.There was 1 patient (0.6％) whose nasobiliary drain was wrongly ligated.Of 42 patients with nasobiliary drainage using the transoral route,6 patients failed.There was 1 patient (2.4％) who had no output from the nasobiliary drain.There was 1 patient (2.4％) who had intestinal juice output from the nasobiliary drain.Primary closure failed in 1 patient (2.4％) with resultant bile leakage.Pancreatitis occurred in 4 patients (9.5％) after the operation.The success rate of establishing a nasobiliary drainage in the transabdominal group was significantly higher than that in the transoral group,but the complications were less.Conclusions Nasobiliary drainage established through the transabdominal route in laparoscopy surgery for patients with gallbladder and common bile duct calculi was technically easier and had a high success rate.It had less complications.
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Objective To explore the impact of combined laparoscopic and choledochoscopic treatment on bile leak in hepatic hydatid disease at a high attitude region.Methods The clinical data of 50 patients who underwent combined laparoscopic and choledochoscopic treatment were compared with 50 patients who underwent laparoscopic surgery alone for hepatic hydatid internal capsule excision surgery.Results In the combined laparoscopic and choledochoscopic group,the incidence of biliary fistula after surgery was 15％,the incision infection rate was 13％,the length of hospitalization was (11.6 ± 3.8) days and the postoperative time to take off drain was (14.3 ± 7.9) days.These were significantly better than those in the laparoscopic alone group.The operation time in the former group was (108.2 ± 28.4)min,which was slightly longer than the laparoscopy group.Conclusion The combined laparoscopic and choledochoscopic treatment is a safer therapeutic option in treating hepatic hydatid disease with less trauma,faster recovery and shorter hospital stay than laparoscopic surgery alone in a high attitude region.
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Objective To explore the influence of gallbladder contraction function for gallbladderpreserving cholecystolithotomy by laparoscope combined with choledochoscope laparoscope.Methods Seventy-three patients with benign gallbladder diseases were selected.Patients treated with laparoscopic cholecystectomy were enrolled in LC group (31 patients),while those treated with endoscopic minimally invasive cholecystolithotomy (EMIC) were enrolled in EMIC group (42 patients).Operation situation,treatment outcome and postoperative complications were analyzed between two groups.At the same time,the level of cholecystokinin was detected with double antibody sandwich method in two groups,and the gallbladder contraction function of patients in EMIC group were detected with color Doppler.Results All patients were completed surgery without relapse cases.The operation time in EMIC group was longer than that in LC group:(84.6 ± 11.4) min vs.(72.1 ± 13.6) min,t =4.076,P ＜ 0.05.But the intraoperative bleed and postoperative complications in EMIC group were lower than those in LC group:(11.3 ± 4.8) ml vs.(19.6 ± 5.5) ml,t =3.715,P ＜0.05;2.38％ vs.16.14％,x2 =4.469,P ＜0.05.There were no recurrence.The levels of cholecystokinin in two groups before operation had no significant difference (P ＞ 0.05).After treatment for 1,6,12 months,the levels of cholecystokinin in EMIC group were (33.6 ± 10.6),(49.4 ± 12.7),(63.4 ± 14.6)ng/L,in LC group were (21.4 ± 9.1),(11.3 ± 7.4),(6.7 ± 2.7) ng/L,the levels of cholecystokinin in EMIC group were significantly higher than those in LC group (t =3.472,17.514,31.472,P ＜ 0.05 or ＜ 0.01).After treatment for 1 month,the rate of gallbladder contraction in EMIC group was significantly lower than that before treatment:(22.8 ± 4.5)％ vs.(39.2 ± 7.6)％,t =6.003,P ＜ 0.05).After treatment for 6 months,the rate of gallbladder contraction in EMIC group was recovered,after treatment for 12 months,the rate of gallbladder contraction in EMIC group was significantly higer than that before treatment:(48.8 ± 7.6)％ vs.(39.2 ± 7.6)％,t =3.054,P ＜ 0.01.Conclusions Gallbladder-preserving cholecystolithotomy by laparoscope combined with choledochoscope can get less iatrogenic trauma,which contribute to a protective effect on gallbladder contraction function on the base of high stone removal rate.It has promotive value in benign gallbladder diseases.