Laparoscopic combined with duodenoscopic procedures in the treatment of gallbladder stones with common bile duct stones:a clinical analysis of 164 cases / 中国普通外科杂志

ABSTRACT

Objective To investigate the value of combined use of laparoscopic cholecystectomy(LC)and duodenoscopic procedures in the treatment of gallbladder stones with common bile duct stones.Methods We retrospectively analyzed clinical data of 164 cases of gallbladder stones with common bile duct stones treated with laparoscopic cholecystectomy + endoscopic sphincterotomy(EST)from January 2003 to December 2007.Results All the cases underwent ERCP and endoscopic sphincterotomy(EST)followed by LC.In the 164 cases,196 bile duct stones were extracted from 155cases with a success rate of 94.5%.The procedures were unsuccessful in 9 cases,and among them,4 cases had stricture of bile duct more than 2 cm in length,and 5 cases had impacted stones that precluded passage of the guide wire.After EST,6 of the 155 cases had the complication of mild acute pancreatitis and LC was performed after its treatment.The success rate of LC was 96.5% and the average hospital stay was(11?4)d.Conclusions The combined use of EST and ERCP before LC is effective in treatment of gallbladder stones with common bile duct stones,and has broadened the utilization of minimally invasive treatment for bile duct diseases.