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The aim of this study was to evaluate the safety and efficacy of laparoscopic cholecystectomy\u2009+\u2009laparoscopic common bile duct exploration\u2009+\u2009intraoperative endoscopic nasobiliary drainage\u2009+\u2009primary closure (LC\u2009+\u2009LCBDE\u2009+\u2009IO-ENBD\u2009+\u2009PC). The safety of different intubation methods in IO-ENBD was also evaluated.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Method<\/jats:title>\n                <jats:p>From January 2018 to January 2022, 168 consecutive patients with cholecystolithiasis combined with choledocholithiasis underwent surgical treatment in our institution. Patients were divided into two groups: group A (<jats:italic>n<\/jats:italic>\u2009=\u200996) underwent LC\u2009+\u2009LCBDE\u2009+\u2009IO-ENBD\u2009+\u2009PC and group B (<jats:italic>n<\/jats:italic>\u2009=\u200972) underwent LC\u2009+\u2009LCBDE\u2009+\u2009PC. Patient characteristics, perioperative indicators, complications, stone residual, and recurrence rates were analyzed. Group A was divided into two subgroups. In group A<jats:sub>1<\/jats:sub>, the nasobiliary drainage tube was placed in an anterograde way, and in group A<jats:sub>2<\/jats:sub>, nasobiliary drainage tube was placed in an anterograde\u2013retrograde way. Perioperative indicators and complications were analyzed between subgroups.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>No mortality in the two groups. The operation success rates in groups A and B were 97.9% (94\/96) and 100% (72\/72), respectively. In group A, two patients were converted to T-tube drainage. The stone clearance rates of group A and group B were 100% (96\/96) and 98.6% (71\/72), respectively. Common bile duct diameter was smaller in group A [10 vs. 12\u00a0mm, <jats:italic>P<\/jats:italic><jats:bold>\u2009&lt;\u2009<\/jats:bold>0.001] in baseline data. In perioperative indicators, group A had a longer operation time [165 vs.135\u00a0min, <jats:italic>P<\/jats:italic><jats:bold>\u2009&lt;\u2009<\/jats:bold>0.001], but group A had a shorter hospitalization time [10 vs.13\u00a0days, <jats:italic>P<\/jats:italic>\u2009=\u20090.002]. The overall complications were 7.3% (7\/96) in group A and 12.5% (9\/72) in group B. Postoperative bile leakage was less in group A [0% (0\/96) vs. 5.6% (4\/72), <jats:italic>P<\/jats:italic>\u2009=\u20090.032)]. There were no residual and recurrent stones in group A. And there were one residual stone and one recurrent stone in group B (all 1.4%). The median follow-up time was 12\u00a0months in group A and 6\u00a0months in group B. During the follow-up period, 2 (2.8%) patients in group B had a mild biliary stricture. At subgroup analysis, group A<jats:sub>1<\/jats:sub> had shorter operation time [150 vs. 182.5\u00a0min, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001], shorter hospitalization time [9 vs. 10\u00a0days, <jats:italic>P<\/jats:italic>\u2009=\u20090.002], and fewer patients with postoperative elevated pancreatic enzymes [32.6% (15\/46) vs. 68% (34\/50), <jats:italic>P<\/jats:italic>\u2009=\u20090.001].<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>LC\u2009+\u2009LCBDE\u2009+\u2009IO-ENBD\u2009+\u2009PC is safer and more effective than LC\u2009+\u2009LCBDE\u2009+\u2009PC because it reduces hospitalization time and avoids postoperative bile leakage. In the IO-ENBD procedure, the antegrade placement of the nasobiliary drainage tube is more feasible and effective because it reduces the operation time and hospitalization time, and also reduces injury to the duodenal papilla.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00464-022-09601-3","type":"journal-article","created":{"date-parts":[[2022,10,7]],"date-time":"2022-10-07T16:04:12Z","timestamp":1665158652000},"page":"1700-1709","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Efficacy and safety of laparoscopic common bile duct exploration with primary closure and intraoperative endoscopic nasobiliary drainage for choledocholithiasis combined with cholecystolithiasis"],"prefix":"10.1007","volume":"37","author":[{"given":"Zhihong","family":"Zhang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guohui","family":"Shao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanyang","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kejia","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guang","family":"Zhai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xueyuan","family":"Dang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhitang","family":"Guo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhitian","family":"Shi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Renchao","family":"Zou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lixin","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hong","family":"Zhu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bo","family":"Tang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dong","family":"Wei","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lin","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2339-4044","authenticated-orcid":false,"given":"Jiayun","family":"Ge","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2022,10,7]]},"reference":[{"key":"9601_CR1","doi-asserted-by":"publisher","first-page":"28","DOI":"10.1097\/01.sla.0000103069.00170.9c","volume":"239","author":"C Collins","year":"2004","unstructured":"Collins C, Maguire D, Ireland A, Fitzgerald E, O\u2019Sullivan GC (2004) A prospective study of common bile duct calculi in patients undergoing laparoscopic cholecystectomy: natural history of choledocholithiasis revisited. 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