Abstract：
The optimal treatment options for gallstones together with common bile duct stones (CBDS) remain controversial. The aim of this study was to further compare the recurrence rate of stones after synchronous laparoscopic cholecystectomy combined with laparoscopic common bile duct exploration (SLCL) and synchronous laparoscopic cholecystectomy combined with intraoperative endoscopic sphincterotomy (SLCE) and to determine which option is more effective in reducing the rate of repeated recurrence of CBDS and the incidence rate of hepatolithiasis.
We retrospectively investigated the clinical data of patients who underwent SLCL or SLCE at our hepatobiliary center between August 2012 and August 2020. The primary and secondary endpoints of this study were the recurrence of CBDS and the occurrence of hepatolithiasis, respectively.
In total, 1005 patients were enrolled in this study, including 431 patients in the SLCL group and 574 patients in the SLCE group. SLCL was associated with a significantly decreased rate of CBDS recurrence (4.18% vs. 7.84%, P = 0.018), repeated CBDS recurrence (0.70% vs. 3.00%, P = 0.010), and incidence of hepatolithiasis (0.00% vs. 1.05%, P = 0.040). Compared with SLCE, SLCL was an independent protective predictor of the recurrence of CBDS (relative risk, 0.505; 95% confidence interval, 0.286-0.891; P = 0.018) and repeated recurrence of CBDS (relative risk, 0.226; 95% confidence interval, 0.066-0.777; P = 0.018).
SLCL is an optimal treatment option to SLCE for patients with gallstones combined with CBDS.
We retrospectively investigated the clinical data of patients who underwent SLCL or SLCE at our hepatobiliary center between August 2012 and August 2020. The primary and secondary endpoints of this study were the recurrence of CBDS and the occurrence of hepatolithiasis, respectively.
In total, 1005 patients were enrolled in this study, including 431 patients in the SLCL group and 574 patients in the SLCE group. SLCL was associated with a significantly decreased rate of CBDS recurrence (4.18% vs. 7.84%, P = 0.018), repeated CBDS recurrence (0.70% vs. 3.00%, P = 0.010), and incidence of hepatolithiasis (0.00% vs. 1.05%, P = 0.040). Compared with SLCE, SLCL was an independent protective predictor of the recurrence of CBDS (relative risk, 0.505; 95% confidence interval, 0.286-0.891; P = 0.018) and repeated recurrence of CBDS (relative risk, 0.226; 95% confidence interval, 0.066-0.777; P = 0.018).
SLCL is an optimal treatment option to SLCE for patients with gallstones combined with CBDS.
摘要：
背景：胆结石合并胆总管结石（CBDS）的最佳治疗方案仍存在争议。本研究旨在进一步比较同步腹腔镜胆囊切除术联合腹腔镜胆总管探查术(SLCL)与同步腹腔镜胆囊切除术联合术中内镜括约肌切开术(SLCE)后结石复发率，确定哪种方案更有效降低CBDS反复复发率及肝胆管结石发生率。
方法：我们回顾性调查了2012年8月至2020年8月在我们的肝胆中心接受SLCL或SLCE的患者的临床资料。本研究的主要和次要终点是CBDS的复发和肝胆管结石的发生。分别。
结果：总计，本研究招募了1005名患者，包括SLCL组431例患者和SLCE组574例患者。SLCL与CBDS复发率显着降低相关（4.18％vs.7.84%，P=0.018),反复CBDS复发（0.70%vs.3.00%,P=0.010),和肝胆管结石的发病率（0.00%vs.1.05%,P=0.040)。与SLCE相比,SLCL是CBDS复发的独立保护性预测因子(相对风险，0.505；95%置信区间，0.286-0.891；P=0.018）和反复复发的CBDS（相对风险，0.226；95%置信区间，0.066-0.777；P=0.018）。
结论：SLCL是胆结石合并CBDS患者SLCE的最佳治疗选择。
方法：我们回顾性调查了2012年8月至2020年8月在我们的肝胆中心接受SLCL或SLCE的患者的临床资料。本研究的主要和次要终点是CBDS的复发和肝胆管结石的发生。分别。
结果：总计，本研究招募了1005名患者，包括SLCL组431例患者和SLCE组574例患者。SLCL与CBDS复发率显着降低相关（4.18％vs.7.84%，P=0.018),反复CBDS复发（0.70%vs.3.00%,P=0.010),和肝胆管结石的发病率（0.00%vs.1.05%,P=0.040)。与SLCE相比,SLCL是CBDS复发的独立保护性预测因子(相对风险，0.505；95%置信区间，0.286-0.891；P=0.018）和反复复发的CBDS（相对风险，0.226；95%置信区间，0.066-0.777；P=0.018）。
结论：SLCL是胆结石合并CBDS患者SLCE的最佳治疗选择。
