关键词: 胆总管结石, 胆囊结石, 腹腔镜, 十二指肠镜, 乳头括约肌切开

Abstract: Objective: To investigate the clinical effect of laparoscopic cholecystectomy ( LC) combind with endoscopic retrograde cholangiopancreatography(ERCP) and endoscopic sphincterotomy ( EST) in sequential treament of extrahepatic lithiasis．. Methods: From January 2006 to December 2009, The clinical records of 420 consecutive patients suffered from extrahepatic lithiasis were reviewed. The clinical effects were received by followed up. Result: 398 of 420(94.7%) consecutive patients who suffered from common bile duct stones were performed by ERCP+EST successfully. 71 patients had the early complications such as hyperamylasemia,pancreatitis,the bleeding of the duodenum papilla. No patient had the complication of the perforation of intestine. After bile duct stone clearance, except of 57 patients whom had been treated by cholecystectomy,185 of 363 patients underwent LC. 5 patients were found residual stones in the common bile duct by the imaging checking and were cleared by the second step of the ERCP+EST. Follow-up data were available in 311 patients with 6-54 months.During a median follow-up period of 32 months.The rate of follow-up is 74.0%.16(5.1%) patients were found that had the recurrent stones in the common bile duct. Conclusion: It is a safe and effective method for treating patients with extrahepatic lithiasis by EST sequential with LC．

Key words: cholecystolithiasis, gallbladder stone, laparoscopic, duodenoscope, endoscopic sphincterotomy.