Abstract
To evaluate the clinical efficacy of laparoscopic common bile duct exploration (LCBDE) combined with choledochoscopy and primary closure without T-tube drainage in managing acute abdominal pain caused by choledocholithiasis (common bile duct stones, CBDS) and cholecystolithiasis with acute cholecystitis. A single-center prospective study was conducted at the Department of General Surgery, Beijing Fengtai Youanmen Hospital, from April 2024 to February 2025. Sixty-one patients with acute abdominal pain due to CBDS and cholecystolithiasis with acute cholecystitis were randomized into two groups: T-tube-free group (n = 35), Triple-port laparoscopic cholecystectomy (LC) + LCBDE with primary closure; T-tube group (n = 26), Four-port LC + LCBDE with T-tube drainage. Perioperative outcomes were compared between the groups. Baseline characteristics were comparable (all P > 0.05). The T-tube-free group demonstrated superior outcomes in operative time, intraoperative blood loss, postoperative pain, duration of abdominal drainage, and hospital stay (all P < 0.05). Each group had one case of biliary leakage, both resolved conservatively. No mortality, pancreatitis, conversion to open surgery, residual stones, biliary hemorrhage, or strictures occurred in either group. Triple-port LC combined with LCBDE and primary closure without T-tube drainage is safe and feasible for acute abdominal pain. Compared to T-tube drainage, this approach better aligns with the principles of enhanced recovery after surgery (ERAS).
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Data availability
All data generated during this study are included in this published article. Further minor datasets are available from the corresponding author on reasonable request.
Abbreviations
- LCBDE:
-
Laparoscopic common bile duct exploration
- CBDS:
-
Common bile duct stones
- LC:
-
Laparoscopic cholecystectomy
- ERAS:
-
Enhanced recovery after surgery
- CBD:
-
Common bile duct
- RCT:
-
Randomized controlled trial
- ASA:
-
American Society of Anesthesiologists
- BMI:
-
Body Mass Index
- CVS:
-
Critical View of Safety
- MRCP:
-
Magnetic Resonance Cholangiopancreatography
- POD:
-
Postoperative day
- EST:
-
Endoscopic sphincterotomy
- ERCP:
-
Endoscopic Retrograde Cholangiopancreatography
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Funding
This study was supported by the Institutional Research Fund of [Beijing Fengtai Youanmen Hospital] (Grant No. KY-2024-04).
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The manuscript has been read and approved by all the authors; the requirements for authorship have been met; each author believes that the manuscript represents honest work. XRW conducted the literature search, analyzed the data, and wrote the manuscript. YXL and JK provided guidance. XFS, JZ, YPW, HHT, LW, RZR, MW, KL and ZB collected the data. All authors read and approved the final manuscript.
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This study was conducted in accordance with the ethical standards of the Helsinki Declaration and its amendments. The study protocol was approved by the Ethics Committee of [Beijing Fengtai Youanmen Hospital] (Grant No. LL-2024-04). All patients or their legal guardians provided written informed consent prior to participation in the study.
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Wang, X., Kang, J., Li, Y. et al. Prospective randomized trial of triple port laparoscopic cholecystectomy combined with choledochoscopic common bile duct exploration and primary closure for acute abdominal pain. Sci Rep (2026). https://doi.org/10.1038/s41598-026-37034-8
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DOI: https://doi.org/10.1038/s41598-026-37034-8
