Clinical value of laparoscopy combined with choledochoscopy in the treatment of intrahepatic and extrahepatic bile duct stones: a retrospective analysis.

OBJECTIVE

To compare the clinical efficacy, postoperative recovery, and safety of laparoscopy combined with choledochoscopy versus traditional laparotomy for intrahepatic and extrahepatic bile duct stones.

METHODS

Clinical data of 80 patients treated at Wenzhou People's Hospital from January 2022 to December 2024 were retrospectively analyzed. Patients were divided into an observation group (laparoscopy combined with choledochoscopy, n = 42) and a control group (traditional open bile duct exploration, n = 38). Operative parameters, stone clearance, postoperative recovery, complications, and follow-up outcomes were compared.

RESULTS

Operation time was longer in the observation group than in the control group (128.5 ± 32.6 min vs. 98.3 ± 25.4 min, P < 0.001), but intraoperative blood loss was significantly lower (35.4 ± 18.7 mL vs. 42.6 ± 17.3 mL, P < 0.05). No significant differences were found in stone clearance or residual stone rate between groups (both P > 0.05). The observation group showed significantly better outcomes in gastrointestinal function recovery, postoperative ambulation, analgesic use, and hospital stay (all P < 0.01). Total complication rate was lower in the observation group (7.1% vs. 21.1%, P < 0.001). No significant differences were observed in 6-month stone recurrence rate or 3-month liver function between groups (both P > 0.05).

CONCLUSION

Laparoscopy combined with choledochoscopy has a slightly longer operation time but offers less intraoperative blood loss, reduced trauma, faster postoperative recovery, and comparable long-term efficacy compared with traditional laparotomy for intrahepatic and extrahepatic bile duct stones.