To investigate the efficacy and safety of laparoscope combined with choledochoscopic lithotomy for cholangiolithiasis.

Clinical data of 172 patients with cholangiolithiasis treated in the Central People's Hospital of Zhanjiang, Guangdong Province between January 2009 and June 2014 were retrospectively studied. Among the 172 patients, 65 were males and 107 were females with the average age of (44±7) years old. The informed consents of all patients were obtained and the local ethical committee approval had been received. According to the different surgical procedures, the patients were divided into the laparoscope combined with choledochoscopic lithotomy group (minimally invasive group, n=85) and the traditional open lithotomy group (traditional group, n=87). The patients in the minimally invasive group underwent laparoscopic common bile duct exploration + choledochoscopic lithotomy, while the patients in the traditional group underwent open common bile duct exploration + T-tube drainage. The perioperative conditions, postoperative complications and surgical curative effect of the two groups were compared. The data of the two groups were compared using t test , Chi-square test or Fisher's exact probability test.

The intraoperative blood loss of the minimally invasive group was (76±20) ml, which was significantly lower than (206±87) ml of the traditional group (t=-13.42, P<0.05). The postoperative evacuation time, defecation time and time of recovery to semi-liquid diet were respectively (2.4±1.0), (4.2±2.1) and (4.5±1.0) d, which were significantly shorter than (3.5±1.5), (5.3±1.4) and (4.9±1.5) d of the traditional group (t=-5.645, -4.051, -2.053; P<0.05). The postoperative length of hospital stay of the minimally invasive group was (7.3±2.5) d, which was significantly shorter than (9.5±2.7) d of the traditional group (t=-5.542, P<0.05). The incidence of incision fat liquefaction or poor healing of the minimally invasive group was 1% (1/85), which was significantly lower than 8% (7/87) of the traditional group (χ²=4.575, P<0.05). The cure rate of the minimally invasive group and the traditional group was both 91% and no significant difference was observed (χ²=0.002, P>0.05).

Laparoscope combined with choledochoscopic lithotomy for cholangiolithiasis has the same efficacy with open lithotomy and has the advantages of high safety, quick postoperative recovery and short length of hospital stay.