[摘要] 目的 探討运用胆道镜联合腹腔镜手术治疗原发性肝胆管结石的临床疗效。 方法 选取2015年1月～2016年12月期间我院205例原发性肝胆管结石患者，按手术方式不同将其分为研究组、常规组，其中研究组103例，常规组102例。研究组采用胆道镜联合腹腔镜手术进行治疗，常规组行传统开腹术，对比两组手术相关指标、VAS评分及并发症发生率。 结果 研究组与常规组术中出血量、肛门排气时间、下床活动时间、住院时间等相关指标对比均有统计学差异（t=-13.649、-17.290、-12.471、-8.779，P<0.05）；研究组与常规组术前VAS评分比较差异无统计学意义（t=-0.717，P=0.474），研究组术后VAS评分显著低于常规组，组间对比具有统计学差异（t=-4.807，P=0.000）；研究组术后并发症发生率为3.88%，显著低于常规组的12.75%，组间对比具有统计学意义（χ2=5.160，P=0.023）。 结论 相较于传统开腹术，运用胆道镜联合腹腔镜治疗原发性肝胆管结石手术效果更优，有利于减少术中出血量，促进术后肛门排气，减轻术后疼痛程度，降低并发症发生率，缩短患者住院时间，进一步促进术后康复，具备临床意义与实施价值。
　　[关键词] 胆道镜；联合；腹腔镜手术；原发性肝胆管结石
　　[中图分类号] R657.4 [文献标识码] B [文章编号] 1673-9701（2017）36-0052-03
　　[Abstract] Objective To investigate the clinical efficacy of cholangioscopy combined with laparoscopic surgery in the treatment of primary hepatolithiasis. Methods Totally 205 patients with primary hepatolithiasis in our hospital from January 2015 to December 2016 were divided into study group（n=103） and conventional group（n=102） according to the different surgical methods. The study group was treated with cholangioscopy combined with laparoscopic surgery. The conventional group underwent traditional laparotomy. The surgery-related indicators， VAS score and complication rate between the two groups were compared. Results There were statistically significant differences in the related indicators including intraoperative blood loss， anal exhaust time， ambulation time and hospital stay between the study group and conventional group（t=-13.649， -17.290， -12.471， 8.779， P<0.05）. There was no statistically significant difference in the VAS score between the study group and the conventional group before surgery（t=-0.717， P=0.474）. The postoperative VAS score in the study group was significantly lower than that of the conventional group， and the difference between the two groups was significant（t=-4.807， P=0.000）. The postoperative complication rate in the study group was 3.88%， which was significantly lower than that in the conventional group（12.75%， χ2=5.160， P=0.023）. There was statistical significance between groups. Conclusion The surgical effect of cholangioscopy combined with laparoscopy in the treatment of primary hepatolithiasis is better than that of the traditional open surgery. And cholangioscopy combined with laparoscopy will help reduce the amount of bleeding during operation， promote postoperative anal exhaust， reduce postoperative pain and reduce complications rate， shorten hospital stay， and further promote postoperative recovery， which has clinical significance and implementation value.