ObjectiveTo discuss the feasibility and superiority of EST combined with LC in treating cholecystolithiasis with common bile duct stones.
MethodsPatients underwent LC (laparoscopic cholecystectomy) preceded by EST（endoscopic sphincterotomy） and removal of common bile duct stones. ENBD(Endoscopic nasal biliary drainage tube)was placed if EST failure and then the patient underwent LC+laparoscopic biliary duct exploration(LCBDE),or open operative bile duct exploration.
ResultsIn 91 of the 99 cases,LC preceded by EST and stone removal was successful,while EST following LC was successful in 3 cases, and stone removal by EST was unsuccessful in 3 cases.Two cases less than 15 years of age underwent LC+LCBDE through the cystic duct and did not undergo EST.Three cases, who had EST failure, underwent LC+LCBDE with primary suture of the common bile duct or LCBDE with T-tube drainage of common bile duct,or open bile duct exploration with primary suture of the common bile duct(ENBD was in place). All patients were discharged from hospital without serious complications.
ConclusionsEST combined with LC in treating cholecystolithiasis with common bile duct stones is a safe and effective method. Combination of endoscopic and laparoscopic procedures fully reflects the advantage of minimally invasive therapy.