To evaluate the safety and efficacy of laparoscopic cholecystectomy, common bile duct exploration combined with primary suture for cholecystolithiasis complicated with choledocholithiasis.

Clinical data of 100 patients with cholecystolithiasis complicated with choledocholithiasis admitted to the First Affiliated Hospital of Hunan Normal University from June 2017 to March 2019 were retrospectively analyzed. The informed consents of all patients were obtained and the local ethical committee approval was received. According to different treatments, all patients were divided into laparoscopic group (n=50) and open surgery group (n=50). In the laparoscopic group, 31 patients were male and 19 female, aged 24-74 years with a median age of 47 years. Laparoscopic cholecystectomy, common bile duct exploration combined with primary suture were performed. In the open surgery group, 32 cases were male and 18 female, aged 25-74 years with a median age of 47 years. Open cholecystectomy, common bile duct exploration combined with T-tube drainage were performed. Perioperative conditions and clinical efficacy were observed in two groups. The operation time and intraoperative blood loss between two groups were statistically compared by t test. The total effective rate and incidence of postoperative complications were statistically compared by Chi-square test.

The average operation time, intraoperative blood loss, exhaust time and length of postoperative hospital stay in the laparoscopic group were (90±17) min, (43±13) ml, (31±5) h and (7.7±1.2) d, significantly less than those in the open surgery group (118±21) min, (103±26) ml, (48±8) h and (9.9±1.6) d, respectively (t=-3.22, -6.35, -5.47, -3.48; P<0.05). The total effective rate in the laparoscopic group was 96%(48/50), significantly higher than 78%(39/50) in the open surgery group (χ2=7.16, P<0.05). The incidence of postoperative complications in the laparoscopic group was 6%(3/50), significantly lower than 20%(10/50) in the open surgery group (χ2=4.33, P<0.05).

Compared with open surgery, laparoscopic cholecystectomy, common bile duct exploration combined with primary suture has the advantages of higher efficacy, minimally invasive, quicker recovery and higher safety in the treatment of cholecystolithiasis complicated with choledocholithiasis.