LCBDE, three ports, and primary continuous suture of common bile duct for the treatment of cholelithiasis and choledocholithiasis: a retrospective study

Background: Laparoscopic cholecystectomy (LC) plus laparoscopic common bile duct exploration (LCBDE) is convenient in the treatment of cholelithiasis in combination with choledocholithiasis. It has the advantage of accelerated recovery. This retrospective study aimed to summarize the experience of cholelithiasis and choledocholithiasis treatment via LC plus LCBDE approach in Eastern China. Methods: Patients diagnosed with cholelithiasis and choledocholithiasis between July 2019 and October 2021 at the Xishan People’s Hospital of Wuxi City were included in the study. During treatment, patients who received LC+LCBDE+primary suturing of the CBD were assigned to the LCBDE-P group, and those who received LC+LCBDE+T-tube drainage of CBD were assigned to the LCBDE-T group. The measurement data were compared between the two groups. P -values < 0.05 indicated statistical significance. Results: A total number of 88 patients (48 females and 40 males) were divided into two groups: LCBDE-P (n=50) and LCBDE-T (n=38). Multiple linear regression analysis showed that LCBDE-P affected the risk-adjusted hospitalization stay (unstandardized coefficient, -5.352 days; 95% CI: -0.387 to -4.761; P < 0.001) and medical cost (unstandardized coefficient, -0.494 RMB; 95% CI: -0.712 to -0.277; P < 0.001) with significant differences. On the other hand, no significant differences were detected in the operation time, intraoperative hemorrhage, clearance rate of CBD stones, postoperative liver function, and postoperative complications ( P > 0.05) between the two groups. Conclusions: LCBDE is a safe and feasible strategy for the management of cholelithiasis and choledocholithiasis. Compared to LCBDE-T, LCBDE-P decreases hospital stays and medical costs during hospitalization.