目的 探讨改良腹腔镜胆总管切开取石术的临床价值.方法 回顾分析4年余78例采用改良腹腔镜胆总管切开取石术治疗胆囊结石合并胆总管结石的临床资料.全组均为60岁以上的老年患者.结果全组手术均获成功,术后4周回院行T管造影和拔除T管.77例无术后并发症.仅1例发生小切口感染.拔管后无并发症,均获痊愈.结论 改良腹腔镜胆总管切开取石术,能在直视下切开缝合胆总管、放置T管,对胆总管结石的治疗效果良好,尤其适于不能长时间耐受气腹的老年患者.“,”Objective To discuss the clinical value of modified laparoscopic lithotomy of common bile duct. Methods Clinical data of 78 patients over the age of 60 with gallstone and choledocholithiasis who underwent modified laparoscopic lithotomy of common bile duct in the past four years were analysed. Results All operations were successful. T-tubes were withdrawn 4 weeks after operation. Of the 78 cases,77 cases hat no complications and only one case had a small incision infection. All patients recovered without complications after with drawal of T-tube. Conclusions Modified laparoscopic lithotomy of common bile duct can allow incision and suture of common bile duct and placement of T-tube under direct vision,and achieves excellent therapeatic results in the treatment of common duct stones,especially in elderly patients who cannot tolerate a long period of pneumoperitoneum.