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.