Abstract:Objective To systematically evaluate the safety and efficiency of laparoscopic cholecystectomy (LC) combined with laparoscopic common bile duct exploration (LCBDE) and endoscopic retrograde cholangiopancreatography (ERCP)/endoscopic sphincterotomy (EST) combined LC for patients with cholecystolithiasis and choledocholithiasis. Methods Randomized controlled trial (RCT) comparing the efficacy of LC+LCBDE and ERCP/EST+LC published from January 2010 to December 2018 was searched in databases such as PubMed,Embase,Cochrane Library,China National Knowledge Infrastructure,and Wanfang database.Literature screening was performed according to the inclusion and exclusion criteria.The full text of the literature was read to extract relevant research data.Data analysis was performed using RevMan5.3 software. Results A total of 10 literatures with 1 502 cases were included,of which 756 cases were in the LC+LCBDE group and 746 cases were in the ERCP/EST+LC group.Meta analysis showed that LC+LCBDE group and ERCP/EST+LC group had no statistically significant difference in the total complication rate (P>0.05).In terms of the type of complications,the pancreatitis,cholangitis and bleeding in the LC+LCBDE group occurred more frequently,while bile leakage occurred more frequently in the LC+LCBDE group.There were no significant differences in the stone removal rate,conversion rate of laparotomy,operation time,and length of hospital stay between the two groups (all P>0.05). Conclusions LC+LCBDE and ERCP/EST+LC have similar effectiveness and safety.Both of them have many related complications,and there is no significant difference in operation time and hospital stay.The LC+LCBDE group is slightly superior in hospitalization costs.The above conclusions need to be verified and updated with more forward RCTs.