Single-Incision Plus One-Port Laparoscopic Choledocholithotomy with Primary Suture for Choledocholithiasis

The purpose of this study protocol is to describe and verify the safety, feasibility, and efficacy of single-incision plus one-port (S+1) laparoscopic choledocholithotomy with primary suture for the treatment of choledocholithiasis, aiming to balance minimal invasiveness, operative precision, and enhanced patient recovery S+1 group. This study enrolled patients with choledocholithiasis who underwent the target surgical procedure and selected concurrent patients who received traditional multi-port laparoscopic choledocholithotomy with T-tube drainage as the control group. The specific surgical protocol includes placing a transumbilical multi-channel trocar and a 5 or 10 mm subxiphoid auxiliary port to optimize instrument distribution; making a longitudinal incision on the common bile duct (CBD) using an electrified small needle for stone extraction; and suturing the CBD with 5-0 absorbable sutures. Intraoperative choledochoscopy was used to confirm the clearance of stones, and perioperative indicators, including operative time, intraoperative blood loss, postoperative hospital stay, and complication rate, were compared between the two groups. Results showed no statistically significant differences in intraoperative blood loss or total complication rate between the two groups; however, the S+1 group had significantly shorter operative time, postoperative flatus time, and hospital stay. Complications (such as biliary leakage and residual stones) in both groups were resolved by minimally invasive interventions without the need for reoperation. This surgical procedure provides a safe and effective minimally invasive option for the treatment of choledocholithiasis. While avoiding T-tube-related complications, it also has the advantages of cosmetic effect and accelerated recovery, providing a basis for its clinical application in appropriately selected patients.