Laparoscopic cholecystectomy plus common bile duct exploration for extrahepatic bile duct stones and postoperative recurrence-associated risk factors.

BACKGROUND

There remain controversies regarding the surgical treatment of extrahepatic bile duct stones (EHBDSs) in clinical practice.

AIM

To explore the curative effect of laparoscopic cholecystectomy (LC) plus common bile duct exploration (CBDE) for the surgical treatment of EHBDSs and to analyze the risk factors that affect postoperative stone recurrence.

METHODS

Eighty-two patients with EHBDSs admitted between March 2017 and March 2023 were selected. Among them, patients treated with open choledocholithotomy plus LC or open cholecystectomy (OC) were set as the control group ( = 40), and those treated with LC plus CBDE served as the observation group ( = 42). The surgical outcomes of the two groups were compared, the surgical complications and Gastrointestinal Quality of Life Index (GIQLI) scores were counted, and the one-year prognostic recurrence was recorded. Independent factors for postoperative recurrence were determined using univariate and multivariate analyses.

RESULTS

The two groups were comparable in the stone residual rate ( > 0.05). The operation time ( < 0.05), intraoperative bleeding ( < 0.05), and total complication rate ( = 0.005) were lower in the observation group than in the control group. The observation group exhibited a marked increase in the GIQLI score, which was higher than the control group ( < 0.05). A lower one-year recurrence rate was determined in the observation group the control group ( = 0.027). Sphincter of Oddi dysfunction [odds ratio (OR) = 5.712, = 0.007] and the treatment scheme of open choledocholithotomy plus LC or OC (OR = 6.771, = 0.008) were the independent risk factors for one-year recurrence in patients after surgery.

CONCLUSION

LC plus CBDE for patients with EHBDSs can reduce stone residuals, intraoperative bleeding, complications, and postoperative recurrence.