{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T10:57:33Z","timestamp":1786964253082,"version":"build-2736575974"},"reference-count":11,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T00:00:00Z","timestamp":1769040000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,2,12]],"date-time":"2026-02-12T00:00:00Z","timestamp":1770854400000},"content-version":"vor","delay-in-days":21,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sci Rep"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    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\u2009=\u200935), Triple-port laparoscopic cholecystectomy (LC)\u2009+\u2009LCBDE with primary closure; T-tube group (n\u2009=\u200926), Four-port LC\u2009+\u2009LCBDE with T-tube drainage. Perioperative outcomes were compared between the groups. Baseline characteristics were comparable (all\n                    <jats:italic>P<\/jats:italic>\n                    \u2009&gt;\u20090.05). The T-tube-free group demonstrated superior outcomes in operative time, intraoperative blood loss, postoperative pain, duration of abdominal drainage, and hospital stay (all\n                    <jats:italic>P<\/jats:italic>\n                    \u2009&lt;\u20090.05). 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).\n                  <\/jats:p>","DOI":"10.1038\/s41598-026-37034-8","type":"journal-article","created":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T21:04:45Z","timestamp":1769115885000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Prospective randomized trial of triple port laparoscopic cholecystectomy combined with choledochoscopic common bile duct exploration and primary closure for acute abdominal pain"],"prefix":"10.1038","volume":"16","author":[{"given":"Xirang","family":"Wang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jian","family":"Kang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuxiang","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaofeng","family":"Sun","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yunpeng","family":"Wu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hehui","family":"Tao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruizhou","family":"Rong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miao","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kang","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhen","family":"Ban","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,1,22]]},"reference":[{"issue":"3","key":"37034_CR1","doi-asserted-by":"publisher","first-page":"482","DOI":"10.3390\/antibiotics12030482","volume":"12","author":"ML Costanzo","year":"2023","unstructured":"Costanzo, M. L., D\u2019Andrea, V., Lauro, A. & Bellini, M. I. Acute cholecystitis from biliary lithiasis: Diagnosis, management and treatment. Antibiotics 12(3), 482 (2023).","journal-title":"Antibiotics"},{"issue":"3","key":"37034_CR2","doi-asserted-by":"publisher","first-page":"11","DOI":"10.1177\/14574969221111027","volume":"111","author":"DM Shabanzadeh","year":"2022","unstructured":"Shabanzadeh, D. M. et al. National clinical practice guidelines for the treatment of symptomatic gallstone disease: 2021 recommendations from the Danish surgical society. Scand. J. Surg. 111(3), 11\u201330 (2022).","journal-title":"Scand. J. Surg."},{"issue":"11","key":"37034_CR3","doi-asserted-by":"publisher","first-page":"8562","DOI":"10.1007\/s00464-023-10442-x","volume":"37","author":"P Fugazzola","year":"2023","unstructured":"Fugazzola, P. et al. Prospective validation of the Israeli Score for the prediction of common bile duct stones in patients with acute calculous cholecystitis. Surg. Endosc. 37(11), 8562\u20138569 (2023).","journal-title":"Surg. Endosc."},{"issue":"11","key":"37034_CR4","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000041902","volume":"104","author":"MA Chaouch","year":"2025","unstructured":"Chaouch, M. A. et al. Meta-analysis of randomized controlled trials comparing single-stage laparoscopic versus two-stage endoscopic management followed by laparoscopic cholecystectomy of preoperatively diagnosed common bile duct stones. Medicine 104(11), e41902 (2025).","journal-title":"Medicine"},{"key":"37034_CR5","doi-asserted-by":"crossref","unstructured":"Liu, J. & Duan, X. Sequential comparison of single-stage laparoscopic common bile duct exploration combined with cholecystectomy. Updates Surg. (2025).","DOI":"10.1007\/s13304-025-02205-1"},{"issue":"3","key":"37034_CR6","doi-asserted-by":"publisher","first-page":"1683","DOI":"10.1007\/s00464-022-09723-8","volume":"37","author":"J Zhu","year":"2023","unstructured":"Zhu, J. et al. Minimally invasive management of concomitant gallstones and common bile duct stones: An updated network meta-analysis of randomized controlled trials. Surg. Endosc. 37(3), 1683\u20131693 (2023).","journal-title":"Surg. Endosc."},{"key":"37034_CR7","doi-asserted-by":"publisher","first-page":"192","DOI":"10.14701\/ahbps.25-010","volume":"29","author":"RH Zhang","year":"2025","unstructured":"Zhang, R. H. et al. Usefulness of intraoperative choledochoscopy in laparoscopic subtotal cholecystectomy for severe cholecystitis. Ann. Hepatobiliary Pancreat. Surg. 29, 192\u2013198 (2025).","journal-title":"Ann. Hepatobiliary Pancreat. Surg."},{"issue":"1","key":"37034_CR8","first-page":"1010","volume":"95","author":"X Wang","year":"2025","unstructured":"Wang, X. et al. Clinical effect analysis of three-port laparoscopic and choledochoscopic common bile duct exploration without T-tube in the treatment of emergency cholecystolithiasis combined with common bile duct stones. Hum. Biol. 95(1), 1010\u20131014 (2025).","journal-title":"Hum. Biol."},{"issue":"6","key":"37034_CR9","first-page":"358","volume":"29","author":"L Wang","year":"2023","unstructured":"Wang, L. & Chen, Z. Comparison of laparoscopic common bile duct exploration and endoscopic retrograde cholangiopancreatography in the treatment of bile duct stones and analysis of risk factors for postoperative acute pancreatitis. Altern. Ther. Health Med. 29(6), 358\u2013363 (2023).","journal-title":"Altern. Ther. Health Med."},{"issue":"2","key":"37034_CR10","doi-asserted-by":"publisher","first-page":"145","DOI":"10.1089\/lap.2024.0345","volume":"35","author":"F Liu","year":"2025","unstructured":"Liu, F. et al. Short-term efficacy of LCBDE+LC versus ERCP\/EST+LC in the treatment of cholelithiasis combined with common bile duct stones: A retrospective cohort study. J. Laparoendosc. Adv. Surg Tech. A. 35(2), 145\u2013151 (2025).","journal-title":"J. Laparoendosc. Adv. Surg Tech. A."},{"issue":"1","key":"37034_CR11","doi-asserted-by":"publisher","first-page":"224","DOI":"10.1186\/s12893-022-01676-y","volume":"22","author":"A Kaneta","year":"2022","unstructured":"Kaneta, A. et al. Efficacy of endoscopic gallbladder drainage in patients with acute cholecystitis. BMC Surg. 22(1), 224 (2022).","journal-title":"BMC Surg."}],"container-title":["Scientific Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41598-026-37034-8","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-026-37034-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-026-37034-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,12]],"date-time":"2026-02-12T09:49:47Z","timestamp":1770889787000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41598-026-37034-8"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,22]]},"references-count":11,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["37034"],"URL":"https:\/\/doi.org\/10.1038\/s41598-026-37034-8","relation":{"has-preprint":[{"id-type":"doi","id":"10.21203\/rs.3.rs-6779576\/v1","asserted-by":"object"}]},"ISSN":["2045-2322"],"issn-type":[{"value":"2045-2322","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,22]]},"assertion":[{"value":"29 May 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"19 January 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"22 January 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}},{"value":"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.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Obtained.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}}],"article-number":"5993"}}