Objective To explore the clinical value of rigid choledochoscope under sheath protection in the treatment of intrahepatic bile duct calculus and common bile duct calculus through laparoscopic common bile duct approach. Methods A total of 115 patients with intrahepatic and extrahepatic bile duct calculus were selected as research objects. According to the operation method, patients were divided into rigid choledochoscope group (n=58) and fiber choledochoscope group (n=57). The rigid choledochoscope group was treated with rigid choledochoscope under the sheath protection through laparoscopic common bile duct approach, and the fiber choledochoscope group was treated with fiber choledochoscope through laparoscopic common bile duct approach.The operation time, intraoperative blood loss, postoperative hospital stay, caculus clearance rate, liver function (fasting venous blood levels of total bilirubin, direct bilirubin, alkaline phosphatase, γ-glutamyltransferase) on the first day after operation, and postoperative complications were compared between the two groups. Results The operation time was shorter and the calculus clearance rate was higher in the rigid choledochoscope group than those in the fiber choledochoscope group, with statistically significant differences (all P<0.05). There were no statistically significant differences in intraoperative blood loss, postoperative hospital stay, incidence of postoperative complications, and the levels of total bilirubin, direct bilirubin, alkaline phosphatase, γ-glutamyltransferaseon the first day after operation between the two groups (all P>0.05). Conclusion Rigid choledochoscope under sheath protection in the treatment of intrahepatic bile duct calculus and common bile duct calculus through laparoscopic common bile duct approach has short operation time and high calculus clearance rate, which is a safe and efficient surgical strategy with certain potential application value.

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