Volume 23 Issue 5
May  2025
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CHEN Zhengmin, LIU Zixiang. Clinical application of the simultaneous surgical treatment for gallstones with common bile duct stones by ERCP/EST combined LC[J]. Chinese Journal of General Practice, 2025, 23(5): 773-775. doi: 10.16766/j.cnki.issn.1674-4152.003998
Citation: CHEN Zhengmin, LIU Zixiang. Clinical application of the simultaneous surgical treatment for gallstones with common bile duct stones by ERCP/EST combined LC[J]. Chinese Journal of General Practice, 2025, 23(5): 773-775. doi: 10.16766/j.cnki.issn.1674-4152.003998
shu

Clinical application of the simultaneous surgical treatment for gallstones with common bile duct stones by ERCP/EST combined LC

doi: 10.16766/j.cnki.issn.1674-4152.003998

  • Department of General Surgery, the Second Affiliated Hospital of Bengbu Medical University, Bengbu, Anhui 233000, China

Funds:

 2022AH051476

 2023fyjyxm15

  • Received Date: 2024-11-26
    Available Online: 2025-08-14
    Abstract
  •   Objective  To explore the clinical application of a combined approach involving endoscopic retrograde cholangiopancreatography (ERCP)/endoscopic sphincterotomy (EST) in conjunction combined with laparoscopic cholecystectomy (LC) for the simultaneous treatment of gallstones and common bile duct stones.  Methods  A retrospective analysis was conducted on the medical records of 34 cases of gallbladder stones combined with common bile duct stones treated in the Hepatobiliary Pancreatic Ward of the Second Affiliated Hospital of Bengbu Medical University from February 2022 to June 2024, ERCP bile duct stone extraction was completed under full intravenous anesthesia or intubation general anesthesia, followed by LC.  Results  A total of 31 cases in the entire group successfully completed ERCP/EST combined with LC simultaneous surgery. In addition, three cases were switched to laparoscopic common bile duct dissection (LCBDE) for different reasons, while in one instance, the intubation process was unsuccessful due to the presence of a nipple in the duodenal diverticulum. The LCBDE was promptly substituted, and a plastic stent was left in the bile duct following stone removal. This was followed by primary bile duct suturing. In the course of ERCP surgery, a particular instance of complexity was encountered in the process of crushing and extracting stones. Following the insertion of a nasobiliary drainage tube, the administration of LCBDE was promptly discontinued and the bile duct was sutured during the initial stage of the procedure, subsequent to the removal of the stone. In one instance of difficulty with ERCP intubation, the procedure was immediately transitioned to LCBDE. During the operation, bile turbidity was observed, accompanied by purulent flocculent material and significant edema of the bile duct wall. The T-tube was left in situ. Postoperatively, 9 patients developed hyperamylasemia. There were no severe complications such as perforation, cholangitis, pancreatitis or deaths.  Conclusion  The safety and feasibility of utilizing ERCP/EST in conjunction with LC for the concurrent surgical management of gallstones and common bile duct stones has been demonstrated, resulting in a streamlined simplifies the surgical process and reduced hospitalization duration. This approach merits further clinical promotion and implementation.

     

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