To evaluate the efficacy of two approaches in treatment for chloecystocholedocholithiasis: laparoscopy combined with duodenoscopy (laparo-endoscopic rendenvous, LER) and two-stage treatment- laparoscopic cholecystectomy (LC) following preoperative endoscopic retrograde cholangiopancreatography (ERCP).

From January 2009 to November 2010, fifty-one cases of chloecystocholedocholithiasis were adopted to our hospital. Twenty-five cases underwent LER, while the other 26 cases underwent a two-stage treatment: LC 5 days after the preoperative ERCP. Operating time, cleanses rate of common bile duct stones, surgical success rate, incidence of complications of postoperative pancreatitis and the overall length of hospital stay were compared.

Both groups had one case converting to laparotomy because of severe adhesions of gallbladder triangle. Surgical success rates were 96.0% vs 96.2% (χ²=0.481, P=0.509). Average operative time were (85±20) min vs (120±18) min (t=-0.613, P<0.01). Pancreatitis complications were 4% vs 11% (χ²=5.063, P=0.020). The average hospital stay were (5.0±1.2)d vs (11±1.6)d (Z=-6.230, P<0.01). The whole group of patients had no complications of bleeding and perforation related to duodenal microscopic operations.

LER technique of the single-stage treatment for chloecystocholedocholithiasis is safe, effective, and has a lower incidence of postoperative complications of pancreatitis, greatly shortening the overall length of hospital stay, compared with the two-stage treatment. Its promotion and application still needs a large sample of clinical studies and long-term follow-up evaluation.