To investigate the impact of percutaneous transhepatic cholangioscopic lithotomy (PTCSL) and laparoscopic common bile duct exploration (LCBDE) on stress response and stone clearance rate in patients with intrahepatic biliary stones.

A retrospective analysis was conducted on 120 patients with intrahepatic biliary stones admitted from May 2021 to May 2024. They were divided into the PTCSL group (n=56, undergoing PTCSL) and the LCBDE group (n=64, undergoing LCBDE) according to the surgical method. Statistical analysis was performed using SPSS 28.0 software. Ranked data were analyzed by the rank-sum test; counting data were expressed as [cases (%)] and analyzed by the χ² test; measurement data conforming to normal distribution were expressed as (±s), with inter-group comparison using the independent samples t test and intra-group comparison using the paired samples t test. P<0.05 was considered statistically significant.

The total effective rate of stone clearance in the LCBDE group was 96.9%, which was higher than 85.7% in the PTCSL group (P<0.05). At 3 days after surgery, the levels of C-reactive protein (CRP), tumor necrosis factor-α (TNF-α), epinephrine (EP), and cortisol (Cor) in both groups were higher than those before surgery, while the levels of γ-glutamyl transferase (GGT), alanine aminotransferase (ALT), and total bilirubin (TBIL) were lower than those before surgery. Moreover, the postoperative levels in the LCBDE group were lower, with statistically significant differences between the two groups (P<0.05). There were no statistically significant differences in surgical-related indicators or the total incidence of postoperative complications between the two groups (P>0.05).

Compared with PTCSL, LCBDE achieves better stone clearance efficacy in patients with intrahepatic biliary stones and has a smaller impact on postoperative stress response and early liver function indicators.