Abstract: Objective To observe the effect of percutaneous transhepatic biliary drainage（PTCD）in elderly patients with cholecystolithiasis and common bile duct stones undergoing laparoscopic biliary exploration.
Methods Cholecystolithiasis with choledocholithiasis in 60 cases，30 cases of elderly patients with cholecystolithiasis and common bile duct stones who underwent PTCD and laparoscopic cholecystectomy who were treated in the Hepatobiliary and Pancreatic Surgery of the First People's Hospital of Suqian City were selected as the PTCD group.At the same time，30 elderly cholecystolithiasis patients undergoing laparoscopic choledocholithotomy patients with common bile duct stones served as the control group.On the basis of the control group，the PTCD group received PTCD before surgery and was decompressed and drained for 3～6 days after surgery.The surgical indicators，postoperative recovery，complications，pain（VAS score），and recurrence rate of stones within 1 year were compared between the two groups.
Results The laparoscopic operation time in the PTCD group was shorter than that in the control group，and the intraoperative blood loss was lower than that in the control group（P<0.05）.Both groups successfully completed the operation without conversion to open surgery.There was no significant difference in the residual stone rate between the two groups after surgery（P> 0.05）.At 12 hours after operation，the VAS score of the PTCD group was（3.9±1.0）and had no significant difference with the control group（3.8±1.1）（P> 0.05）.The hospitalization time，drainage tube removal time，and postoperative exhaust time in the PTCD group were shorter than those in the control group，and the differences were statistically significant（P<0.05）.There was no significant difference in the incidence of pulmonary infection，biliary tract infection，bile duct hemorrhage，bile leakage，and total complications between the two groups（P>0.05）.One case was lost to follow-up in the PTCD group，2 cases were lost to follow-up in the control group，and 1 year was followed up.There was a statistically significant difference in recurrence rates between the two groups（3.45% vs.3.57%，P>0.05）.
Conclusion For older patients > 65 years old and common bile duct diameter ≥1.0cm with choledocholithiasis and common bile duct stones，PTCD 〖LM〗can shorten the operation time，reduce tissue damage and promote postoperative recovery.

Key words: percutaneous transhepatic biliary drainage, laparoscopic bile duct exploration, gallbladder stones, common bile duct stones