Abstract: Objective　To compare the curative effect between endoscopic retrograde cholangiopancreatography（ERCP） / endoscopic sphincterotomy（EST） and laparoscopic common bile duct exploration（LCBDE） on cholecystolithiasis with choledocholithiasis.Methods　In this retrospective study，we enrolled 104 cases of cholecystolithiasis with choledocholithiasis who underwent emergency laparoscopic cholecystectomy and LCBDE or ERCP/EST in Hospital of Xinjiang Production and Construction Corps from January 2012 to March 2016 and assigned 52 of them undergoing ERCP/EST to ERCP/EST group，and the other 52 undergoing LCBDE to LCBDE group.We recorded both groups' average common bile duct clearance，average stone residual rate，duration of procedure，total duration of procedure，postoperative length of stay，average incidence of postoperative complications and follow-up results.Results　Compared with ERCP/EST group，LCBDE group presented higher average stone residual rate，longer duration of procedure，and longer postoperative length of stay（P<0.05），but they had similar average common bile duct clearance and total duration of procedure（P>0.05）．Furthermore，the average incidence of postoperative pancreatitis，postoperative bleeding，bile leakage，incision complications，pneumonia and so on did not differ significantly between the groups（P>0.05）．15 cases were lost to follow up，the recorded data of 9 cases were found with errors，and 6 died during the follow-up period.The expected outcome was failed to achieve in 5 cases treated by ERCP/EST，as well as 4 treated by LCBDE.Conclusion　For patients needing emergency laparoscopic cholecystectomy，ERCP/EST is recommended instead of LCBDE，for it can achieve better results with lower stone residual rate.

Key words: Cholelithiasis；Cholangiopancreatography, endoscopic retrograde；Biliary tract surgical procedures；Comparative effectiveness research

摘要： 目的　比较内窥镜逆行胰胆管造影/十二指肠乳突肌切开术（ERCP/EST）与腹腔镜胆管探查术（LCBDE）治疗胆囊结石合并胆总管结石的疗效。方法　回顾性选取2012年1月—2016年3月新疆生产建设兵团医院行急诊胆囊切除术（LC）的胆囊结石合并胆总管结石并行LCBDE或ERCP/EST的患者104例为研究对象，随机将患者分为ERCP/EST组和LCBDE组，各52例。观察两组患者结石清除率、结石残留率、手术时间、手术总时间、术后住院时间、术后并发症发生率及随访结果。结果　LCBDE组患者结石残留率高于ERCP/EST组，手术时间、术后住院时间长于ERST/EST组（P<0.05）；两组患者结石清除率、手术总时间比较，差异无统计学意义（P>0.05）；两组患者术后胰腺炎、术后出血量、胆漏、切口并发症、肺炎、其他并发症发生率比较，差异无统计学意义（P>0.05）。15例患者失访，9例患者登记信息出现偏差，6例患者随访期间死亡。ERCP/EST组中5例患者未获得预期治疗，LCBDE组中4例患者未获得预期治疗。结论　在腹腔镜下行急诊LC的胆囊结石合并胆总管结石患者中，ERCP/EST的结石残留率低于LCBDE，其疗效更为显著，值得临床医生推广。

关键词: 胆结石, 胰胆管造影术, 内窥镜逆行, 胆管外科手术, 疗效比较研究