ObjectiveTo investigate the safety and efficacy of laparoscopy combined with choledochoscopy in treatment of intrahepatic and extrahepatic bile duct stones. MethodsA total of 50 patients with intrahepatic and extrahepatic bile duct stones were chose. Among them, 12 cases of cholecystolithiasis complicated with choledocholithiasis were treated with laparoscopic cholecystectomy and T tube drainage; 18 cases of cholecystolithiasis complicated with choledocholithiasis and hepatolithiasis were treated with laparoscopic cholecystectomy, common bile duct incision and choledochoscope stone removal combined with T tube drainage; 20 cases of common bile duct stones complicated with intrahepatic bile duct stones were treated by laparoscopic common bile duct exploration combined with bile duct stone removal and T tube drainage. ResultsThe stone removal surgery were successful in both 50 cases; postoperative bile leakage occurred in 2 cases, after positive anti-infection and adequate drainage for 8-10 d, the bile leakage stopped； 1 cases of postoperative bile duct bleeding were treated with right hepatic artery embolization after conservative treatment failed. There were no deaths, no conversion to open surgery, no significant liver function damage complications. After T tube drainage for 12-14d, cholangiography showed that, 46 patients without residual stones, 4 cases with intrahepatic biliary residual stone(8.0%)；after 3-6 months of operate, according the T tube cholangiography, T tube choledochoscopic lithotomy surgery was conducted again. Follow-up for 6-24 months, ultrasound or CT scan showed no stone recurrence. ConclusionLaparoscopy combined with choledochoscopy in the treatment of intrahepatic and extrahepatic bile duct stones have the advantages of fewer traumas, less complications. It is safe and feasible.

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