Objective To discuss the treatment method and opportunity for patients with gallbladder stones and extrahepatic bile duct stones who failed endoscopic removal of common bile duct stones by endoscopic retrograde cholangiopancreaticography (ERCP). Methods 12 patients, with gallbladder stones and extrahepatic bile duct stones, failed endoscopic stone extraction (ESE), underwent emergency one-stage laparoscopic cholecystectomy (LC) and Laparoscopic common bile duct exploration (LCBDE). Results All of the patients were successfully completed LC +LCBDE and stones were completely removed. Hyperamylasemia occurred in 3 cases and there was no bile leakage, intestinal leakage, cholangitis, pancreatitis, biliary bleeding and other complications. Conclusions Emergency LCBDE has been shown to be a safe and effective salvage procedure for failed ESE.

BACKGROUND:Currently, vertebral compression fractures are the most common osteoporotic fracture in postmenopausal women;however, incidence of refracture has aroused increasing attention due to a lack of standard treatment. OBJECTIVE:To evaluate whether vertebroplasty combined with anti-osteoporosis treatment can reduce refracture rate fol owing osteoporotic vertebral compressive fractures. METHODS:Eighty-nine patients with osteoporotic vertebral compressive fractures undergoing vertebroplasty were divided into control group (n=38) and treatment group (n=51) after making an informed choice about treatment. Chest/lumbar X-ray and bone mineral density determinations were performed through outpatient or inpatient fol ow-up. The spinal stability, bone mineral density and refracture rate of patients in both groups were fol owed up. RESULTS AND CONCLUSION:Seventy-eight patients achieved complete fol ow-up (ranged from 6-39 months, average 26.73 months). There was no significant difference in the spinal stability between both groups (P>0.05), while rare bone trabecula was found in the control group. There was a significant difference in bone mineral density between both groups at postoperative 12, 24, and 36 months (P<0.05). The refracture rate in the treatment group was significantly lower than that in the control group (P<0.05). Our results indicate that anti-osteoporosis treatment can effectively reduce the incidence of refracture after vertebroplasty in patients with osteoporotic vertebral compressive fractures, and this study found satisfactory short-and medium-term clinical outcomes.