Abstract: Objective To study the clinical effect of laparoscopic cholecystectomy (LC) at different stages after endoscopic sphincterotomy (EST) in patients with choledocholithiasis and cholecystolithiasis. Methods From July 2016 to July 2019, 165 patients with choledocholithiasis and cholecystolithiasis were enrolled in this study. All patients underwent EST before LC.According to the interval time between the two methods, the patients were divided into observation group (LC within 48-72 hours after EST, 82 cases) and control group (LC after 72 hours after EST, 83 cases).The operation time, bleeding volume during LC, total hospital stay and anal exhaust time after LC were observed. The conversion rate to laparotomy and the occurrence of complications were analyzed. The differences of neutrophil counts between the two groups were compared. Results The time of LC operation, the amount of bleeding during LC operation, the total time of hospitalization and the time of anal exhaust after LC operation in the observation group were significantly shorter than those in the control group (P<0.05).The rate of conversion to laparotomy in the observation group was 3.66%, significantly lower than 14.46% in the control group (P<0.05).There was no significant difference in the incidence of complications between the two groups (P>0.05).The number of neutrophils in gallbladder ampulla of observation group was significantly lower than that of control group (P<0.05). Conclusion LC is safe and feasible for patients with choledocholithiasis and cholecystolithiasis within 48-72 hours after EST. It can shorten the operation time, reduce intraoperative bleeding and reduce the conversion rate to laparotomy.

Key words: EST, LC, Choledocholithiasis, Gallstone