Sequential comparison of single-stage laparoscopic common bile duct exploration combined with cholecystectomy.

Abstract

Laparoscopic cholecystectomy (LC) combined with laparoscopic common bile duct exploration (LCBDE) is used to treat gallbladder (GB) stones combined with common bile duct (CBD) stones. Patients with GB stones combined with CBD stones who underwent single-stage LC + LCBDE surgery in our center from January 2020 to November 2023 were retrospectively analyzed and divided into LC-BDE and BDE-LC groups. LC-BDE was performed in patients with cystic duct diameter ≥ 0.5 cm, and BDE-LC was performed in patients with cystic duct diameter < 0.5 cm. Baseline data, preoperative conditions, operative details, postoperative hospitalization, postoperative care, and complication rates were compared between patients in the two groups. A total of 240 patients were included, including 72 in the LC-BDE group and 168 in the BDE-LC group. There was a significant difference between the two groups in terms of intraoperative blood loss (5 (0, 16) mL vs. 16 (10, 20) mL, P < 0.001). There were no statistically significant differences between the two groups in terms of operative time (130.2 (110.0, 168.6) min vs. 125.0 (105.0, 150.0) min, P = 0.112), and postoperative complications such as bile leakage (8.3 vs. 11.9%, P = 0.415). Different operative sequences of cholecystectomy and common bile duct exploration in the single-stage surgical treatment of GB stones combined with CBD stones were acceptable in terms of bile duct stone clearance and postoperative complication rates.