关键词: 胆总管结石；胆囊结石；内镜逆行胰胆管造影；腹腔镜胆囊切除；手术治疗

Abstract: Objective To evaluate the safety and feasibility of primary endoscopic retrograde cholangiopancreatolithiasis (ERCP) plus laparoscopic cholecystectomy (LC) in patients with choledocholithiasis combined with cholecystolithiasis.Methods From January 2023 to August 2024,185 patients with common bile duct stones combined with gallbladder stones were treated at our hospital.Patients who underwent ERCP+LC during the same surgical period were assigned to Group A(94 patients),and those who underwent LC+ERCP in separate sessions during the same hospital stay were assigned to Group B(91 patients).The gender,age,total hospitalization costs,number and size of stones,whether a drainage tube was left in place,intraoperative blood loss,duration of anesthesia,time to postoperative bowel gas passage,length of hospital stay,incidence of postoperative cholangitis,incidence of postoperative pancreatitis(PEP),rate of residual stones in the bile ducts,and changes in preoperative and postoperative neutrophils,neutrophil percentage,total serum bilirubin,indirect serum bilirubin,alanine aminotransferase,aspartate aminotransferase,and γ-glutamyl transferase were recorded for both groups of patients.Results Compared to Group B[(9.7±2.0)d],the hospital stay duration for patients in Group A[(8.6±2.6)d] was significantly reduced(P<0.05).The duration of anesthesia for patients in Group A[(2.5±0.8)h] was also significantly shorter than that for Group B[(3.7±0.5)h],with a statistically significant difference(P<0.05).Similarly,the total hospitalization costs for patients in Group A[(23969±7421)yuan] were lower than those for Group B[(25427±5236)yuan],and this difference was statistically significant(P<0.05).Conclusion The one-stage ERCP combined with LC treatment protocol for common bile duct stones with gallbladder stones is safe and feasible,with the potential advantages of reducing hospital stay,costs,and duration of anesthesia.

Key words: common bile duct stones;gallstones;endoscopic retrograde cholangiopancreatography；laparoscopic cholecystectomy；surgery