1. Laparoscopic cholecystectomy (LC) plus laparoscopic common bile duct exploration (LCBDE) is preferred, i.e., simultaneous laparoscopic cholecystectomy and common bile duct dissection for stone extraction. The advantages of this method are: (1) short hospital stay; (2) low treatment cost; and (3) complete treatment effect. If the method without T-tube placement is adopted, but with one-stage suture or internal stent drainage, the patient can be discharged 5 days after the operation as if he had received a simple laparoscopic cholecystectomy. We have used this method to treat 120 cases of gallbladder stones combined with common bile duct stones, and for the first time in China, we have used the technique of self-exfoliating biliary stents (below), with patients ranging in age from 16 to 90 years old, all of whom have obtained good results. The disadvantage of this treatment method is that the operation time is longer than that of simple cholecystectomy, so it is not suitable for old and seriously ill patients. Tian Mingguo, Department of Hepatobiliary Surgery, People’s Hospital of Ningxia Hui Autonomous Region
2. laparoscopic cholecystectomy (LC) plus endoscopic bile duct stone extraction (ERCP/EST), which means that stones in the common bile duct are first removed endoscopically by non-surgical methods, and then laparoscopic cholecystectomy (LC) is completed. (2) for small stones embedded in the distal common bile duct, it is more convenient to remove the stones through endoscopic incision than through choledochoscopy during surgery; (3) small stones in the gallbladder can be discharged by themselves after ERCP/EST, and it is possible to avoid cholecystectomy. The disadvantages of this treatment method are: (1) long hospital stay and high treatment cost; (2) stone extraction under endoscopy, especially after sphincterotomy, the function of the distal bile duct sphincter is impaired, and postoperative bile and intestinal reflux is likely to occur, resulting in recurrent cholangitis and stone recurrence; (3) risk of causing pancreatitis and bleeding. This method is suitable for elderly and critically ill patients.