To explore the surgical techniques and clinical effect of combined application of laparoscopy, choledochoscopy, duodenoscopy, dilatable catheter and balloon nasobiliary drainage (LCDND) in treating bile duct stones and papillary obstruction around duodenal diverticulum.

Clinical data of 51 patients with cholecystolithiasis, choledocholithiasis and duodenal diverticulum papilla obstruction were retrospectively analyzed from June 2002 to March 2017.

Fifty-one cases have been successfully removed the gallbladder by laparoscopy and gallstones through the duct incision with choledochoscopy. Step by step dilatable catheter expanded duodenal papilla and indwelling balloon nasobiliary was used in 68.6% (35/51); push the stones into the lumen was applied in 11.8% (6/51); step by step dilatable catheter in combination with balloon catheter expanded duodenal papilla and indwelling balloon nasobiliary were used in 3.9% (2/51); step by step dilatable catheter expanded duodenal papilla, duodenoscopic papillary sphincterotomy with micro incision or small incision and indwelling balloon nasobiliary has been done in 13.7% (7/51); Choledochoscopic examination and indwelling T shape tube drainage due to residual stone in the CBD was used in 2.0% (1/51). No residual stones were found after the nasobiliary drainage. Bile leakage has been cured in one case (2.0%). Two patients (3.9%) had a slight pancreatitis. No case of intestine and bile duct perforation, bleeding, severe pancreatitis or death occurred. The total postoperative complication rate was 5.9% (3/51).

Based on the preliminary research result of limited cases in our hospital. LCDND for treatment of the cholecystolithiasis, choledocholithm, papillary obstruction around duodenal diverticulum is safe and effective for selective patients.

Cholelithiasis; Laparoscopes; Duodenoscopes