Abstract: Objective The aim of this study was to compare the efficacy and safety of laparoscopic common bile duct exploration (LCBDE) or endoscopic sphincterotomy (EST) and laparoscopic cholecystectomy (LC) combination in the treatment of patients with gallbladder stone and choledocholithiasis. Methods 150 patients with gallbladder stones and choledocholithiasis were admitted to our hospital between April 2017 and April 2020, and 77 patients in observation group underwent LCBDE and LC, and 73 patients in control underwent EST and LC combination surgery. They were followed-up for 12 months after surgery. Serum interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) levels were detected by ELISA. Results The operation time and intraoperative blood loss in observation group were (143.3±17.7) min and (24.3±13.0) mL, significantly longer or much more than [(96.7±10.8) min and (16.7±7.2) mL, P<0.05], the postoperative hospitalization stay and medical cost were (6.2±1.3) d and (3.2±1.0) ten thousands yuan, significantly shorter or less or than [(7.1±1.5) d and (4.3±1.1) ten thousands yuan, P<0.05] in the control; at day five after surgery, serum IL-6 level and peripheral white blood cell count were (27.7±6.2) μg/L and (9.1±1.1)×10⁹/L, significantly lower than [(30.5±7.7) μg/L and (10.5±1.6)×10⁹/L, P<0.05] in the control group; no stone residual in the two groups was found by sonography three months after surgery, and at 12 months of follow-up, the stone recurrence in the observation was 7.8%, not significantly different compared to 11.0% in the control (P＞0.05); two weeks after surgery, the incidence of bile fistula in the observation was 10.4%, significantly higher than 1.4%(P＜0.05), while the incidences of pancreatitis and hyperamylasemia were 2.6% and 1.3%, significantly lower than 13.7% and 16.4% (P＜0.05) in the control. Conclusion The application of LCBDE and LC combination in the treatment of patients with gallbladder stone and choledocholithiasis could shorten hospitalization stay and reduce medical cost, while the stone clearance by the two surgical methods is similar, and the appropriate surgical choice could be made by clinicians.

Key words: Gallbladder stone, Choledocholithiasis, Laparoscopic cholecystectomy, Common bile duct exploration, Endoscopic sphincterotomy, Therapy