关键词: 胆结石, 胰胆管造影术, 内窥镜逆行, 胆管外科手术, 疗效比较研究

Abstract: Objective　To compare the curative effect between endoscopic retrograde cholangiopancreatography（ERCP） / endoscopic sphincterotomy（EST） and laparoscopic common bile duct exploration（LCBDE） on cholecystolithiasis with choledocholithiasis.Methods　In this retrospective study，we enrolled 104 cases of cholecystolithiasis with choledocholithiasis who underwent emergency laparoscopic cholecystectomy and LCBDE or ERCP/EST in Hospital of Xinjiang Production and Construction Corps from January 2012 to March 2016 and assigned 52 of them undergoing ERCP/EST to ERCP/EST group，and the other 52 undergoing LCBDE to LCBDE group.We recorded both groups' average common bile duct clearance，average stone residual rate，duration of procedure，total duration of procedure，postoperative length of stay，average incidence of postoperative complications and follow-up results.Results　Compared with ERCP/EST group，LCBDE group presented higher average stone residual rate，longer duration of procedure，and longer postoperative length of stay（P<0.05），but they had similar average common bile duct clearance and total duration of procedure（P>0.05）．Furthermore，the average incidence of postoperative pancreatitis，postoperative bleeding，bile leakage，incision complications，pneumonia and so on did not differ significantly between the groups（P>0.05）．15 cases were lost to follow up，the recorded data of 9 cases were found with errors，and 6 died during the follow-up period.The expected outcome was failed to achieve in 5 cases treated by ERCP/EST，as well as 4 treated by LCBDE.Conclusion　For patients needing emergency laparoscopic cholecystectomy，ERCP/EST is recommended instead of LCBDE，for it can achieve better results with lower stone residual rate.

Key words: Cholelithiasis；Cholangiopancreatography, endoscopic retrograde；Biliary tract surgical procedures；Comparative effectiveness research