Abstract: Objective The aim of this study was to investigate endoscopic retrograde cholangiopancreatography (ERCP)/endoscopic sphincterotomy (EST) in combination with laparoscopic cholecystectomy (LC) in treatment of patients with common bile duct stones (CBDS) and acute cholangitis (AC). Methods A total of 118 patients with CBDS and AC were encountered in our hospital between January 2023 and May 2025, and of them, 67 patients in the observation group underwent ERCP/EST and LC, and another 51 patients in the control group received laparoscopic common bile duct exploration (LCBDE) and LC. All patients were followed-up for three months. Results Intraoperative blood loss and postoperative exhaust time in the observation group were (52.3±3.5)mL and (32.6±2.1)h, both significantly less or shorter than [(58.7±4.9)mL and (35.3±2.6)h, respectively, P＜0.05],while total operation time, hospital stay and medical cost were (2.9±0.6)h, (10.7±1.6)d and (22.0±4.0)thousand yuan, all significantly longer or much more than [(2.1±0.4)h, (6.6±1.2)d and (18.0±3.0)thousand yuan,respectively, P＜0.05] in the control;by day five after operation, serum ALT, AST and GGT levels in the observation group were (46.5±5.1)U/L, (41.2±5.0)U/L and (92.8±8.6)U/L, all much lower than [(58.6±6.7)U/L, (55.2±6.2)U/L and (115.4±10.5)U/L,respectively, P＜0.05] in the control;post-operationally, incidence of complications in the observation group was 10.5%, not significantly different compared to 11.8% in the control (P＞0.05);there was no significant difference as respect to stone clearance rate between the two groups (97.0% vs. 96.1%, P>0.05). Conclusion Both ERCP/EST combined with LC or LCBDE and LC could be performed in dealing with patients with CBDS and AC, and the choice might depend on surgeons skills and patients’ conditions.

Key words: Common bile duct stone, Acute cholangitis, Endoscopic retrograde cholangiopancreatography, Endoscopic sphincterotomy, Laparoscopic common bile duct exploration, Laparoscopic cholecystectomy, Therapy