关键词: 胆囊结石, 胆总管结石, 腹腔镜胆囊切除术, 胆总管探查术

Abstract:

Objective To explore the changes in immune-inflammatory indicators and the short-term therapeutic effect of laparoscopic cholecystectomy （LC） + laparoscopic transcystic common bile duct exploration （LTCBDE） surgery for the treatment of gallbladder stones combined with common bile duct stones. Methods This study adopted a retrospective analysis method. A total of 803 patients with gallbladder stones and common bile duct stones who underwent surgical intervention at the Department of Hepatobiliary Surgery in the Affiliated Hospital of Chengde Medical University from June 2021 to June 2025 were selected as the research subjects. The patients were grouped and compared according to different surgical methods. They were divided into Group A （treated with LTCBDE + LC surgery）， consisting of 467 cases， and Group B （treated with LC + LCBDE + PDC surgery）， with 336 cases. The perioperative and hospitalization data， liver function indicators， inflammation-related indicators， and the occurrence of complications were compared between the two groups of patients. Results The perioperative and hospitalization data of patients in Group A were significantly lower than those in Group B （P < 0.05）. The levels of alanine aminotransferase （ALT）， aspartate aminotransferase （AST）， and alkaline phosphatase （ALP） in Group A after surgery were significantly lower than those in Group B， while the level of serum albumin （ALB） was significantly higher in Group A than in Group B （P < 0.05）. The levels of white blood cell count （WBC）， C-reactive protein （CRP）， and interleukin-6 （IL-6） after surgery in Group A were significantly lower than those in Group B （P < 0.05）. The incidence of postoperative complications was significantly higher in Group A than in Group B （11.56% vs. 8.93%， P < 0.05）. Conclusions Both the LTCBDE + LC surgery and the LC + LCBDE + PDC surgery demonstrate excellent short-term efficacy and safety when treating gallbladder stones combined with common bile duct stones. The LTCBDE + LC surgery is more suitable for patients with relatively simple conditions because of its advantages such as minimal trauma， rapid recovery， and preservation of biliary physiological functions. In contrast， the LC + LCBDE + PDC surgery is characterized by thorough stone removal and fewer long-term complications， rendering it more appropriate for the treatment of complex cases.

Key words: gallbladder stones, common bile duct stones, laparoscopic cholecystectomy, common bile duct exploration