Objective: To compare the clinical efficacy and safety of novel peroral cholangioscopy-assisted bedside stone removal and biliary drainage and LCBDE in the treatment of bile duct stones with acute obstructive suppurative cholangitis.

Methods: The clinical data of patients with bile duct stones and acute obstructive suppurative cholangitis admitted to the Affiliated Hospital of Hebei University from January 2022 to December 2024 were retrospectively analyzed. According to different treatment methods, they were divided into the Endoscopy group and the LCBDE group. The success rate of one-time stone removal, operative time, postoperative hospital stay, and the incidence of postoperative complications were compared between the two groups.

Results: Both the Endoscopy group and the LCBDE group achieved a high stone clearance rate, and there was no statistically significant difference in the overall postoperative complication rate (P > 0.05). However, the Endoscopy group has more advantages in reducing operative time, hospital stay and postoperative severe complications.

Conclusion: The novel peroral cholangioscopy-assisted bedside one-stage stone removal and biliary drainage is safe, feasible, and simple to operate in the treatment of bile duct stones with acute obstructive suppurative cholangitis. It can significantly reduce complications and shorten the hospital stay, with high safety and good clinical application value, providing a new and effective option for the clinical treatment of such patients.