Abstract: Objective The aim of this study was to investigate the immediate laparoscopic cholecystectomy (LC) and laparoscopic common bile duct exploration (LCBDE) in treatment of patients with simultaneous cholecystolithiasis and choledocholithiasis. Methods 73 patients with simultaneous cholecystolithiasis and choledocholithiasis were encountered in our hospital between September 2017 and September 2021, and were randomly divided into observation (n=39) and control (n=34) groups. The patients in the observation group received LC and immediate LCBDE, and those in the control received endoscopic sphincterotomy (EST) followed by LC three days later. All patients were followed-up for 12 months after surgery. The pain was evaluated by visual analogue scale (VAS) and serum C-reactive protein (CRP) level was detected by ELISA. The peripheral blood white blood cell (WBC) counts and the percentages of neutrophil cells (NEUT) were routinely obtained. Results There was no significant difference in stone residual rate between the two groups (5.1% vs. 2.9%, P>0.05); the operation time in the observation group was significantly longer than that in the control group [(140.1±35.2) min vs. (119.7±30.4)min, P<0.05], while the hospitalization time was significantly shorter than that in the control group [(10.9±2.1)d vs. (14.5±2.6)d, P<0.05], the VAS score was significantly lower than that in the control group [(2.3±0.4) vs. (3.1±0.7), P<0.05], and the percentages of persistent analgesia pump needed was significantly lower than that in the control group (35.9% vs. 61.8%, P<0.05); at day 5 after surgery, serum CRP level in the observation was(71.5±16.1)mg/L, much lower than [(90.1±20.4) mg/L, P＜0.05], the WBC count was (9.3±1.4)×10⁹/L, much lower than [(11.3±1.8)×10⁹/L, P＜0.05], and the percentage of NEUT cells was (74.5±6.9)%, much lower than [(82.9±7.5)%, P＜0.05] in the control; the incidences of post-operational complications, such as infection, bleeding, pancreatitis, bile leakage and reflux cholangitis in the observation was 18.0%, much lower than 38.2%(P＜0.05) in the control; at the end of 12 month follow-up, there was no significant difference in the recurrence rate of stones between the two groups (5.1% vs. 8.8%, P>0.05). Conclusion The LC and immediate LCBDE in the treatment of patients with simultaneous cholecystolithiasis and choledocholithiasis could shorten hospital stay times, with reduced post-operational complications.

Key words: Cholecystolithiasis, Choledocholithiasis, Laparoscopic cholecystectomy, Laparoscopic common bile duct exploration, Endoscopic sphincterotomy, Therapy