To investigate the effect and safety of endoscopic retrograde cholangiopancreatography (ERCP) for refractory common bile duct stones.

A prospective study of 92 patients with choledocholithiasis admitted from January 2017 to June 2019 was conducted. The patients were divided into ERCP group and LCBDE group by random number table method. There were 46 cases in each group. SPSS20.0 software was used for data processing. Independent sample t test was used for the measurement data of liver function indicators in the two groups. Fisher’s exact probability test or χ² test were used for the data of lithotomy success rate and complication rate in the two groups. P<0.05 was considered statistically significant.

In the ERCP group, the success rate of one-time stone extraction was 82.6% (38/46), the success rate of second-time stone extraction was 71.4% (5/7), the total success rate of stone extraction was 93.5% (43/46), and the use rate of mechanical crushed stone was 82.6% (38/46); In the LBDEL group, the one-time stone extraction success rate was 73.9% (34/46), the second-time stone extraction success rate was 72.7% (8/11), the total stone extraction success rate was 91.3% (42/46), and the use rate of mechanical crushed stone was 76.1% (35/46). There was no statistically significant difference between the two groups in the success rate of stone removal and the utilization rate of mechanical gravel (P>0.05). The level of ALT, AST, and TBIL at 7 days after operation in the two groups was lower than the preoperative level, and the difference was statistically significant (P<0.05); The levels of ALT, AST and TBIL in ERCP group were significantly lower than those in LBDEL group 7 days after operation (P<0.05). There was no significant difference in the incidence of postoperative complications between the two groups (P>0.05).

ECRP lithotripsy is safe and effective in refractory choledocholithiasis. It is similar to laparoscopic choledocholithotomy. ERCP has more advantages in improving patients’ perioperative conditions and promoting postoperative recovery.