To investigate the efficacy of laparoscopic ultrasound-assisted guidewire-guided duodenoscopy via the cystic duct in the treatment of gallbladder stones combined with non-dilated common bile duct stones.

A retrospective analysis was performed on the clinical data of 139 patients with gallbladder stones and non-dilated common bile duct stones admitted from October 2020 to March 2023. According to different surgical methods, the patients were divided into a study group (n=73 cases) and a control group (n=66 cases). The study group underwent laparoscopic ultrasound-assisted guidewire-guided duodenoscopy for common bile duct lithotomy via the cystic duct combined with laparoscopic cholecystectomy (LC), while the control group underwent endoscopic retrograde cholangiopancreatography (ERCP) combined with LC. Data were processed using SPSS 26.0 statistical software. Measurement data with skewed distribution were expressed as quartiles M(Q₁, Q₃), and intergroup comparisons were performed using the Mann-Whitney U Rank Sum test, while pre-and post-surgical comparisons were conducted using the Wilcoxon test. Enumeration data were expressed as [cases (%)], and intergroup comparisons were made by χ² test or Fisher’s exact probability method. P<0.05 was considered statistically significant.

The study group showed a higher surgical success rate and shorter guidewire intubation time than the control group (P<0.05), with lower incidences of postoperative hyperamylasemia and pancreatitis (P<0.05). There were no significant differences between the two groups in stone residue, bile leakage, or duodenal perforation (P>0.05). The serum amylase (AMY) level in the control group increased at 6 hours postoperatively compared with that before surgery (P<0.05), while no significant difference was observed in the study group (P>0.05). At 5 days postoperatively, serum total bilirubin, alanine aminotransferase (ALT), and aspartate aminotransferase (AST) levels in both groups significantly decreased compared with those before surgery (P<0.05), but no significant intergroup differences were found (P>0.05).

Under strict screening of indications, laparoscopic ultrasound-assisted guidewire-guided duodenoscopy via the cystic duct is safe and effective for the treatment of gallbladder stones combined with non-dilated common bile duct stones.