Abstract:
Objective To investigate the clinical value of one-stage suture following double-endoscopy combined common bile duct exploration and stone extraction in the treatment of choledocholithiasis.
Methods Clinical data of 121 patients who underwent double-endoscopy combined common bile duct exploration and stone extraction from January 2023 to April 2025 were retrospectively analyzed. Before matching, patients were divided into an observation group (n=59, treated with one-stage suture of the common bile duct) and a control group (n=62, treated with T-tube drainage) according to different management methods of the bile duct incision after stone extraction. After 1∶1 propensity score matching, a total of 116 patients were successfully matched, with 58 patients in each group. Data were processed and analyzed using SPSS 23.0 software. Measurement data conforming to normal distribution were expressed as (
±
s) and examined by
t test; enumeration data were examined by
χ2 test.
P<0.05 was considered statistically significant.
Results Compared with the control group, the time to first postoperative flatus and length of hospital stay were significantly shorter in the observation group (P<0.05). At 3 days after surgery, serum levels of C reactive protein (CRP), high-sensitivity C-reactive protein (hs-CRP), serum amyloid A (SAA), total bilirubin (TBIL), aspartate aminotransferase (AST), and alanine aminotransferase (ALT) were significantly lower than those before surgery in both groups (P<0.05). There were no statistically significant differences in proinflammatory factors and liver function indexes between the two groups before surgery and at 3 days after surgery (P>0.05). The total incidence of postoperative complications was significantly lower in the observation group than in the control group (P<0.05). During a median follow-up of 12 months, no common bile duct stenosis or recurrence of choledocholithiasis occurred in either group.
Conclusions Compared with conventional postoperative T-tube drainage, double-endoscopy combined common bile duct exploration with stone extraction and one-stage suture shows equivalent efficacy in relieving biliary obstruction and improving liver function in the treatment of choledocholithiasis. However, the latter can shorten the time to first flatus and hospital stay, and reduce the incidence of postoperative complications.
Key words:
Choledocholithiasis,
Laparoscopes,
Biliary Endoscopy,
Common Bile Duct Incision Stone,
Primary Suture of Bile Duct
Dongdong Ma, Qiang Zhao, Guanru Zhao. Effect of one-stage suture after common bile duct exploration combined with double endoscopy for choledocholithiasis[J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2026, 20(03): 275-278.