title: Minimally invasive phasic treatment protocol for the treatment of extrahepatic bile duct stones.
abstract: OBJECTIVE
  To identify the optimal treatment for extrahepatic bile duct stones using endoscopy, laparoscopy, and the combination of the two in different conditions and to develop phasic treatment protocols for their minimally invasive treatment.
  
  
  METHODS
  Of 2718 cases of extrahepatic bile duct stones collected from June 2005 to December 2011, 50 were randomly selected to receive open bile duct exploration and T-tube drainage, serving as the control group. For the rest, a one-scope protocol, two-scope protocol (two-scope protocol A or two-scope protocol B), or three-scope protocol was adopted according to the specific conditions of stones and the endoscopic treatment results. The treatment outcomes and postoperative clinical indicators of the minimally invasive treatment protocols were analyzed and compared with those of the control group.
  
  
  RESULTS
  Among the 2668 cases of extrahepatic bile duct stones receiving the phasic minimally invasive treatment, the treatment success rate was 97.79%, and there were no severe postoperative complications. Compared with the control group, the minimally invasive treatment protocols had higher success rates, less trauma, and significantly shortened hospital stays.
  
  
  CONCLUSIONS
  The protocols were applied step by step based on the different types and levels of extrahepatic bile duct stones, fully embodying the advantages of the combined minimally invasive treatment of endoscopy and laparoscopy, thus expanding the scope of minimally invasive surgical treatment for extrahepatic bile duct stones and improving treatment success rate.
authors.affiliation: Minimally Invasive Surgery Center of Tianjin Nankai Hospital, 122 Sanwei Rd., Nankai, Tianjin, China.
authors.forename: Mingfang
authors.initials: M
authors.lastname: Qin
authors.forename: Fusheng
authors.initials: F
authors.lastname: Zou
authors.forename: Hongzhi
authors.initials: H
authors.lastname: Zhao
authors.forename: Guoqian
authors.initials: G
authors.lastname: Ding
mesh_terms: D017734:Bile Ducts, Extrahepatic; D002760:Cholangiopancreatography, Endoscopic Retrograde; D017081:Cholecystectomy, Laparoscopic; D002769:Cholelithiasis / Q000150:complications; D002985:Clinical Protocols; D003135:Common Bile Duct / Q000601:surgery; D004384:Duodenoscopy; D042882:Gallstones / Q000150:complications / Q000601:surgery*; D006801:Humans; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*