Abstract:Objective:To evaluate the effect of laparoscopic cholecystectomy (LC) combined with bile duct exploration and stone removal (BDE) and LC with endoscopic sphincterotomy (EST) in treating cholecystolithiasis with choledocholithiasis.
Methods :Among 256 cases of cholecystolithiasis and choledocholithlasis, 132 patients were treated by LC+LCBDE, and 124 cases by EST combined with LC. The operation success rate, operation time and cost, complication rate, and length of hospital stay of the two groups were compared.
Results:There was no statistical difference in the operation success rate, complication rate, stone clearance rate, and average hospital stay between the two groups, but EST+LC group had significantly longer operation time and higher cost.
Conclusions:There are respective indications, advantages and disadvantages in the two groups. EST+LC is the better choice for patients with diameter of CBD＜1.0 cm, stones impacted in the distal CBD, or old age. Otherwise, for patients with diameter of CBD>1.0cm and with multiple choledocholithiasis, especially for middle-aged patients, the better way is LC+LCBDE.