关键词: 复发性胆总管结石, 十二指肠乳头旁憩室, 内镜逆行胰胆管造影, 内镜括约肌切开术, 开放胆道探查术, 腹腔镜胆道探查术

Abstract: Treatment options for recurrent common bile duct stones        ZHAO Hai-ying. Department of General Surgery, the Fourth Affiliated Hospital of China Medical University,Shenyang 110032,China 
Abstract    Recurrent common bile duct stones are common in clinics. The risk factors for the recurrence of common bile duct stones are diabetes,choledochectasia, periampullary diverticula, and previous treatment methods for choledocholithiasis. There are no effective preventive drugs. The treatment options include endoscopic treatment and surgical treatment. Endoscopic treatment includes endoscopic retrograde cholangiopancreatography（ERCP）, endoscopic sphincterotomy（EST）, and endoscopic papillary balloon dilation（EPBD）. Surgical treatment includes cholangioenterostomy, open common bile duct exploration（OCBDE）, and laparoscopic common bile duct exploration（LCBDE）. At present, there is no special treatment guideline or consensus for recurrent common bile duct stones, and the best treatment option is still uncertain. Endoscopic treatment is the first choice for common bile duct stones after cholecystectomy both domestically and internationally. For recurrent common bile duct stones without indications for choledochojejunostomy, both endoscopic treatment and LCBDE are safe and effective treatment methods.LCBDE has advantages such as not damaging the function of the Oddi sphincter and low postoperative stone recurrence rate, especially when there are multiple or large bile duct stones, cast stones, significant dilation of the bile duct, and concurrent periampullary diverticula, it is recommended to choose LCBDE as the first choice.

Key words: recurrent common bile duct stones, periampullary diverticula, endoscopic retrograde cholangiopancreatography, endoscopic sphincterotomy, open common bile duct exploration, laparoscopic common bile duct exploration