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Background <p>Laparoscopic common bile duct exploration and primary suture (LBEPS) present several benefits for treating common bile duct stones, including minimal invasiveness, shorter operative time, and faster postoperative recovery. Nonetheless, the safety of this procedure in patients experiencing acute cholangitis (AC) continues to be a subject of debate.</p> Methods <p>A retrospective analysis was conducted on 162 patients who underwent LBEPS from December 2018 to August 2025.The patients were divided into two groups: those with AC group (<i>n</i> = 36) and non-AC group (<i>n</i> = 126). Key factors, including. baseline characteristics, preoperative and postoperative clinical data, operative time, and postoperative complications, were compared between the two groups.</p> Results <p>There was a significant difference in gender distribution between the two groups (χ²=14.311, <i>P</i> &lt; 0.001). Notable variations were found in preoperative albumin (ALB), total bilirubin (TB), direct bilirubin (DB), white blood cell count (WBC), neutrophil count (NEU), and postoperative platelet count (PLT) (<i>P</i> &lt; 0.05). Patients with AC had a longer preoperative hospital stay (<i>p</i> = 0.036). Overall postoperative complication rates were 8.3% (3/36) in the AC group and 7.1% (9/126) in the non-AC group (<i>P</i> = 0.730), with the majority of complications classified as mild (Clavien-Dindo grade I–II). No postoperative bile leakage was reported in the AC group, whereas 6 cases (4.8%) were observed in the non-AC group (<i>P</i> = 0.340). Stone recurrence was documented in 1 case (2.8%) in the AC group and 2 cases (1.6%) in the non-AC group (<i>P</i> = 0.532).</p> Conclusion <p>With strict patient selection and standardized surgical techniques, AC does not increase the risk of postoperative complications following LBEPS. These findings suggest that the procedure is safe in this patient population and provide evidence for its broader clinical application.</p>

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Validation of the safety of primary laparoscopic common bile duct closure in acute cholangitis: a retrospective cohort study

  • 期刊论文

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  • 发表日期：

    2026年2月2日

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  • Fei Liu,
  • Dai-jiao Gu,
  • Junjiang Pan,
  • Jie Liao,
  • Rong-sen Huang,
  • Zong-hua Chen,
  • Hai-wen Ye

摘要

Background

Laparoscopic common bile duct exploration and primary suture (LBEPS) present several benefits for treating common bile duct stones, including minimal invasiveness, shorter operative time, and faster postoperative recovery. Nonetheless, the safety of this procedure in patients experiencing acute cholangitis (AC) continues to be a subject of debate.

Methods

A retrospective analysis was conducted on 162 patients who underwent LBEPS from December 2018 to August 2025.The patients were divided into two groups: those with AC group (n = 36) and non-AC group (n = 126). Key factors, including. baseline characteristics, preoperative and postoperative clinical data, operative time, and postoperative complications, were compared between the two groups.

Results

There was a significant difference in gender distribution between the two groups (χ²=14.311, P < 0.001). Notable variations were found in preoperative albumin (ALB), total bilirubin (TB), direct bilirubin (DB), white blood cell count (WBC), neutrophil count (NEU), and postoperative platelet count (PLT) (P < 0.05). Patients with AC had a longer preoperative hospital stay (p = 0.036). Overall postoperative complication rates were 8.3% (3/36) in the AC group and 7.1% (9/126) in the non-AC group (P = 0.730), with the majority of complications classified as mild (Clavien-Dindo grade I–II). No postoperative bile leakage was reported in the AC group, whereas 6 cases (4.8%) were observed in the non-AC group (P = 0.340). Stone recurrence was documented in 1 case (2.8%) in the AC group and 2 cases (1.6%) in the non-AC group (P = 0.532).

Conclusion

With strict patient selection and standardized surgical techniques, AC does not increase the risk of postoperative complications following LBEPS. These findings suggest that the procedure is safe in this patient population and provide evidence for its broader clinical application.