Abstract: Objective The aim of this study was to investigate clinical efficacy of laparoscopic cholecystectomy (LC) and choledochoscopy combination in the treatment of patients with recurrent common bile duct stones after biliary tract surgery. Methods 108 patients with recurrent choledocholithiasis who had had biliary tract surgery were enrolled in our hospital between January 2022 and June 2024, and were randomly divided into group A (n=45) and group B (n=63), receiving LC and choledochoscopy combination, or endoscopic retrograde cholangiopancreatography (ERCP)/endoscopic sphincterotomy (EST), and all patients were followed-up for 6 months. Serum endotoxin (ET) level was detected by ELISA, and serum D-lactic acid level was routinely obtained. Results Surgical time, postoperative hospital stay and medical cost in group A were(102.8±19.1)min,(8.4±1.6)d and (20.6±4.0)thousand yuan, all significantly greater or longer than [(81.5±14.6)min, (5.1±1.3)d and (19.0±4.0)thousand yuan, respectively, P<0.05]; three days after surgery, serum ET and D-lactic acid levels in group A were(7.8±1.7)g/L and (0.5±0.1)mmol/L, both not significantly different as compared to [(8.6±1.9)g/L and (0.6±0.1)mmol/L, respectively] in group B(P>0.05); serum ALT, total bilirubin and albumin levels were (45.6±5.8)U/L, (17.2±3.3)μmol/L and (35.7±5.1)g/L, also not significantly different compared to [(43.8±6.0)U/L, (16.4±3.5)μmol/L and (34.6±4.7)g/L, respectively] in group B (P>0.05); incidences of post-operational complications, such as biliary infection, bleeding, bile leakage and acute pancreatitis in the two groups(11.1% vs. 19.1%) was not much different(P>0.05); by end of six-month follow-up, ultrasonography found no stone recurred in group A, but stone recurred in six cases(9.5%)in group B. Conclusion The efficacy of LC and choledochoscopy combination or ERCP/EST in the treatment of patients with recurrent common bile duct stones after biliary tract surgery is both satisfactory, but it seems more post-operational stone recurrence found after ERCP/EST, which needs further observation.

Key words: Choledocholithiasis, Laparoscopic cholecystectomy, Choledochoscopy, Endoscopic retrograde cholangiopancreatography, Endoscopic sphincterotomy, Therapy