Abstract:Background and Aims The staged endoscopic sphincterotomy (EST) plus laparoscopic cholecys-tectomy (LC) is the common treatment method for concomitant gallbladder and common bile duct stones combined with papillary stenosis. However, for large stone or multiple stones, the clearance rate of staged endoscopic stone extraction is lower than that of laparoscopic operation. For the purpose of achieving a high clearance rate of choledocholithiasis with simultaneous treatment of papillary stenosis, and reducing the injury of the anterior wall of the common bile duct by traditional surgery with primary closure of the common bile duct, this study was conducted to investigate the feasibility and clinical value of the one-stage procedure of LC plus laparoscopic transcystic common bile duct exploration (LTCBDE) and EST with primary closure of the common bile duct under the guidance of the ureteral catheter in the treatment of concomitant gallbladder and common bile duct stones combined with papillary stenosis.Methods The clinical data of patients with gallbladder and common bile duct stones combined with papillary stenosis treated by minimally invasive surgery in Chengdu Second People's Hospital from January 2018 to January 2020 were collected. A total of 78 patients meeting the criteria were enrolled, including 40 patients undergoing one-stage procedure of LC+LTCBDE+EST with primary closure of the common bile duct under the guidance of ureteral catheter (observation group) and 38 patients undergoing staged procedures of EST followed by LC (control group), The perioperative clinical data of the two groups of patients were compared.Results The preoperative general data were comparable between the two groups of patients. After operation, no bile leakage occurred in both groups, acute pancreatitis occurred in none of the cases in observation group but occurred in 3 cases (7.9%) in control group. The operative time and length of postoperative hospital stay were shorter and the level of postoperative blood amylase was lower in observation group than those in control group (all P<0.05), while there were no significant differences in terms of intraoperative blood loss, postoperative liver function parameters and nasobiliary drainage time between the two groups (all P>0.05). A total of 62 patients in both groups were followed up for one month to 8 months, with a median follow-up time of 6 months, and in all of them, no repeated abdominal pain and repeated bouts of jaundice occurred, and no biliary stricture and retained or recurrent stones were found.Conclusion Synchronous LC+LCBDE+EST with primary closure under the guidance of the ureteral catheter in the treatment of gallbladder and common bile duct stones combined with papillary stenosis is safe and feasible, and it makes operation more accurate, which can reduce the surgical trauma and complications to a certain extent, and thereby accelerate the postoperative recovery of the patients.