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The efficacy and safety of laparoscopic common bile duct exploration and cholecystectomy for the treatment of difficult common bile duct stones combined with gallstones: a multicenter retrospective study

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Abstract

Purpose

To analyze the benefits of laparoscopic common bile duct exploration and laparoscopic cholecystectomy (LCBDE + LC) versus endoscopic retrograde cholangiopancreatography and/or endoscopic sphincterotomy following laparoscopic cholecystectomy (ERCP/EST + LC) for difficult common bile duct stones combined with gallstones.

Methods

A retrospective analysis of consecutive patients with difficult common bile duct stones combined with gallstones in three hospitals from January 2016 to January 2021 was performed.

Results

ERCP/EST + LC contributed to reducing postoperative drainage time. However, LCBDE + LC showed a higher rate of complete clearance, along with lower postoperative hospital stays, expenses and incidence of postoperative hyperamylasemia, pancreatitis, re-operation and recurrence. In addition, LCBDE + LC showed safe and feasible performance in the elderly and patients with previous upper abdominal surgery.

Conclusion

It is an effective and safe method for LCBDE + LC for difficult common bile duct stones combined with gallstones.

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Data availability

Data relating to this study are available by contacting the corresponding author.

Abbreviations

CBD:

Common bile duct

CI:

Confidence interval

EPBD:

Endoscopic papillary balloon dilation

EPLBD:

Endoscopic papillary large balloon dilation

ERCP:

Endoscopic retrograde cholangiopancreatography

EST:

Endoscopic sphincterotomy

EUS-ERCP:

Endoscopic ultrasound-ERCP

LC:

Laparoscopic cholecystectomy

LCBDE:

Laparoscopic common bile duct exploration

OR:

Odds ratio

PSM:

Propensity score matching

PUAS:

Previous upper abdominal surgery

SD:

Standard deviation

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Author information

Author notes

  1. Wangcheng **e, Zhilong Ma and Jieliang Zuo contributed equally to this work.

Authors and Affiliations

  1. Department of General Surgery, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, Shanghai, China

    Wangcheng **e, Jieliang Zuo, Jian Gong, Weidi Yu, Zhenshun Song & Tingsong Yang

  2. Department of General Surgery, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China

    Zhilong Ma

  3. Department of Pancreatic Surgery, Fudan University Shanghai Cancer Center, Shanghai, China

    Zhilong Ma

  4. Department of General Surgery, Taizhou Fourth People’s Hospital, Taizhou, China

    ** Wang

  5. Department of Gastroenterology, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, Shanghai, China

    Wei Han

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  1. Wangcheng **e
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Contributions

Study conception and design: ZSS and TSY. Acquisition of data: JG, WDY, PW and WH. Analysis and interpretation of data: WCX, ZLM and JLZ. Drafting of manuscript: WCX, ZLM and JLZ. Critical revision of manuscript: all authors. All authors contributed significantly to this work and approved submission of the final version of this manuscript.

Corresponding authors

Correspondence to Zhenshun Song or Tingsong Yang.

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Competing interests

The authors declare no competing interests.

Conflicts of interest

None.

Ethical approval

This study was performed according to the Declaration of Helsinki (as revised in 2013) and approved by the Ethics Committee of the Shanghai Tenth People's Hospital (SHSY-IEC-5.0/22K97/ P01).

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**e, W., Ma, Z., Zuo, J. et al. The efficacy and safety of laparoscopic common bile duct exploration and cholecystectomy for the treatment of difficult common bile duct stones combined with gallstones: a multicenter retrospective study. Langenbecks Arch Surg 408, 195 (2023). https://doi.org/10.1007/s00423-023-02923-3

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