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<p>To evaluate the clinical efficacy of laparoscopic common bile duct exploration (LCBDE) combined with choledochoscopy and primary closure without T-tube drainage in managing acute abdominal pain caused by choledocholithiasis (common bile duct stones, CBDS) and cholecystolithiasis with acute cholecystitis. A single-center prospective study was conducted at the Department of General Surgery, Beijing Fengtai Youanmen Hospital, from April 2024 to February 2025. Sixty-one patients with acute abdominal pain due to CBDS and cholecystolithiasis with acute cholecystitis were randomized into two groups: T-tube-free group (n = 35), Triple-port laparoscopic cholecystectomy (LC) + LCBDE with primary closure; T-tube group (n = 26), Four-port LC + LCBDE with T-tube drainage. Perioperative outcomes were compared between the groups. Baseline characteristics were comparable (all <i>P</i> &gt; 0.05). The T-tube-free group demonstrated superior outcomes in operative time, intraoperative blood loss, postoperative pain, duration of abdominal drainage, and hospital stay (all <i>P</i> &lt; 0.05). Each group had one case of biliary leakage, both resolved conservatively. No mortality, pancreatitis, conversion to open surgery, residual stones, biliary hemorrhage, or strictures occurred in either group. Triple-port LC combined with LCBDE and primary closure without T-tube drainage is safe and feasible for acute abdominal pain. Compared to T-tube drainage, this approach better aligns with the principles of enhanced recovery after surgery (ERAS).</p>

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Prospective randomized trial of triple port laparoscopic cholecystectomy combined with choledochoscopic common bile duct exploration and primary closure for acute abdominal pain

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年1月22日

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  • Xirang Wang,
  • Jian Kang,
  • Yuxiang Li,
  • Xiaofeng Sun,
  • Jun Zhang,
  • Yunpeng Wu,
  • Hehui Tao,
  • Li Wang,
  • Ruizhou Rong,
  • Miao Wang,
  • Kang Liu,
  • Zhen Ban

摘要

To evaluate the clinical efficacy of laparoscopic common bile duct exploration (LCBDE) combined with choledochoscopy and primary closure without T-tube drainage in managing acute abdominal pain caused by choledocholithiasis (common bile duct stones, CBDS) and cholecystolithiasis with acute cholecystitis. A single-center prospective study was conducted at the Department of General Surgery, Beijing Fengtai Youanmen Hospital, from April 2024 to February 2025. Sixty-one patients with acute abdominal pain due to CBDS and cholecystolithiasis with acute cholecystitis were randomized into two groups: T-tube-free group (n = 35), Triple-port laparoscopic cholecystectomy (LC) + LCBDE with primary closure; T-tube group (n = 26), Four-port LC + LCBDE with T-tube drainage. Perioperative outcomes were compared between the groups. Baseline characteristics were comparable (all P > 0.05). The T-tube-free group demonstrated superior outcomes in operative time, intraoperative blood loss, postoperative pain, duration of abdominal drainage, and hospital stay (all P < 0.05). Each group had one case of biliary leakage, both resolved conservatively. No mortality, pancreatitis, conversion to open surgery, residual stones, biliary hemorrhage, or strictures occurred in either group. Triple-port LC combined with LCBDE and primary closure without T-tube drainage is safe and feasible for acute abdominal pain. Compared to T-tube drainage, this approach better aligns with the principles of enhanced recovery after surgery (ERAS).