关键词: 腹腔镜, 逆行性胰胆管造影术, 胆囊结石, 胆总管结石

Abstract: Objective To investigate the clinical application of laparoscopic cholecystectomy(LC) combined with transabdominal anterograde  guided endoscopic retrograde cholangiopancreatography(CP) in the treatment of cholecystolithiasis with  small diameter choledocholithiasis.
Methods The 80 patients with cholecystolithiasis and small diameter choledocholithiasis admitted to our hospital from January 2017 to December 2018 were divided into the control group(40 cases) and the observation group(40 cases) according to random number table method.The observation group was treated with LC and transabdominal anterograde  guided Endoscopic Retrograde Cholangiopancretography,while the control group was treated with oral CP+ LC.The operation conditions,postoperative complications,residual stones,liver function at 3 days before and after operation,pain levels before and 7 days after operation,and quality of life before and 3 months after operation were compared between 2 groups.
Results Compared with the control group,the observation group's intraoperative blood loss,anal exhaust time,gastrointestinal function recovery time,drainage tube placement time,and hospital stay were significantly reduced(P＜0.05),there was no statistical difference in the residual rate of stones.After operation,there was no significant difference in the changes of serum ALT,AST and TB levels between 2 groups(P＞0.05).3 days after operation,the serum ALT,AST and TB levels,VAS Ⅰ,Ⅱ grade Ⅲ and grade Ⅳ were significantly reduced(P＜0.05),and life satisfaction,health index and emotional scores were significantly reduced(all P＜0.05).
Conclusion LC combined with transabdominal anterograde guided ERCP has good clinical effect in the treatment of cholecystolithiasis with small diameter choledocholithiasis,fewer complications,improve quality of life,which is worthy of clinical recommendation.

Key words: laparoscopy, retrograde cholangiopancreatography, cholecystolithiasis, choledocholithiasis