探究腹腔镜胆总管探查术（LCBDE）与内镜逆行胰胆管造影联合内镜十二指肠乳头括约肌切开取石术（ERCP+EST）分别联合腹腔镜胆囊切除术（LC）治疗胆囊结石合并胆总管结石的效果。

回顾性分析2022年1月至2025年1月收治的胆囊结石合并胆总管结石患者的临床资料，根据手术方案不同分为LCBDE组（行LCBDE联合LC治疗）与ERCP+EST组（行ERCP+EST联合LC治疗）。倾向性匹配排除基线资料混杂因素，两组各纳入45例。数据采用SSPS 24.0软件分析，计数资料以[例（%）]表示，进行χ²或Fisher精确检验；符合正态分布的计量资料以（

LCBDE组与ERCP+EST组一次性结石清除率、结石残留率、半年内复发率对比差异均无统计学意义（P>0.05）；LCBDE组引流管置管时间显著长于ERCP+EST组（P<0.05），住院时间显著低于ERCP+EST组（P<0.05），手术时间、出血量及中转开腹率对比差异无统计学意义（P>0.05）；术后2 d，两组患者C反应蛋白（CRP）、总胆红素（TBIL）水平均显著升高（P<0.05），而LCBDE组CRP显著低于ERCP+EST组（P<0.05），两组TBIL对比差异无统计学意义（P>0.05）；LCBDE组胰腺炎率显著低于ERCP+EST组（P<0.05），胆瘘率显著高于ERCP+EST组（P<0.05），两组腹腔感染、胆道狭窄率对比差异无统计学意义（P>0.05）。

LCBDE与ERCP+EST分别联合LC均可治疗胆囊结石合并胆总管结石，LCBDE在术后恢复方面更具优势，适合年轻或结石较大的患者，ERCP+EST操作相对困难且有并发胰腺炎风险，但适合无法耐受全麻及气腹或合并重度梗阻性黄疸患者，临床可根据患者情况选择合适的手术方案。

To investigate the efficacy of laparoscopic common bile duct exploration (LCBDE) and endoscopic retrograde cholangiopancreatography combined with endoscopic sphincterotomy and stone extraction (ERCP+EST), each combined with laparoscopic cholecystectomy (LC), in the treatment of cholecystolithiasis complicated with choledocholithiasis.

Clinical data of patients with cholecystolithiasis and choledocholithiasis admitted from January 2022 to January 2025 were retrospectively analyzed. Patients were divided into the LCBDE group (treated with LCBDE combined with LC) and the ERCP+EST group (treated with ERCP+EST combined with LC) according to different surgical procedures. Propensity score matching was used to eliminate confounding factors of baseline data, with 45 cases in each group. Data were analyzed using SPSS 24.0 software. Enumeration data were expressed as [cases (%)] and analyzed by the χ² test or Fisher's exact test. Measurement data conforming to normal distribution were expressed as (

There were no significant differences in the one-time stone clearance rate, stone residual rate, and recurrence rate within half a year between the LCBDE group and the ERCP+EST group (P>0.05). The drainage tube indwelling time in the LCBDE group was significantly longer than that in the ERCP+EST group (P<0.05), while the hospital stay was significantly shorter (P<0.05). There were no significant differences in operation time, blood loss, or conversion rate to laparotomy between the two groups (P>0.05). At 2 days after operation, the levels of CRP and TBIL in both groups were significantly increased (P<0.05), while CRP in the LCBDE group was significantly lower than that in the ERCP+EST group (P<0.05). There was no significant difference in TBIL between the two groups (P>0.05). The incidence of pancreatitis in the LCBDE group was significantly lower than that in the ERCP+EST group (P<0.05), and the incidence of biliary fistula was significantly higher (P<0.05). There were no significant differences in the rates of abdominal infection or biliary stricture between the two groups (P>0.05).

Both LCBDE and ERCP+EST combined with LC are effective in the treatment of cholecystolithiasis complicated with choledocholithiasis. LCBDE is more advantageous in postoperative recovery and is suitable for young patients or those with large stones. ERCP+EST is relatively difficult to perform and carries a risk of pancreatitis, but is suitable for patients who cannot tolerate general anesthesia and pneumoperitoneum, or those with severe obstructive jaundice. The appropriate surgical procedure can be selected clinically according to individual patient conditions.