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目的 探讨内镜下十二指肠乳头括约肌切开取石术 (EST) 与开放性手术治疗胆总管结石的临床效果.方法 选取胆总管结石患者92例为研究对象,按随机抽签法将其分为治疗组与对照组,每组46例.治疗组患者予以EST治疗,对照组予以传统开放式手术治疗,比较两组患者术后并发症及手术和预后相关指标.结果 治疗组患者术后平均VAS疼痛评分为 (4.14±0.89) 分,低于对照组的 (7.12±1.25) 分,差异有统计学意义 (P＜0.05).治疗组患者术后并发症发生率 (4.35％) 低于对照组 (26.09％),差异有统计学意义 (χ2=6.310,P=0.012).治疗组患者手术指标优于对照组,住院时间短于对照组,VAS疼痛评分低于对照组,差异有统计学意义 (P＜0.05).结论 EST与开放性手术治疗胆总管结石的临床疗效确切,EST术后并发症发生率低,操作简便,手术创伤小,值得临床借鉴.“,”Objective To investigate the clinical effects of endoscopic duodenal sphincterotomy (EST) and open surgery on choledocholithiasis. Methods A total of 92 patients were enrolled and divided into treatment group and control group, with 46 cases in each group. The patients in the treatment group were treated by endoscopic sphincterotomy (EST), and the patients in the control group were treated by conventional open surgery. The clinical effects of the patients in two groups were compared.Results The incidence rate of complication after operation and the average VAS pain score of the patients in the treatment group were lower than those in the control group, the differences were significant (P ＜ 0. 05) . The operative indexes were better than those in the control group, the hospitalization time was shorter than that in the control group, the differences were significant (P ＜ 0. 05) . Conclusions In the treatment of choledocholithiasis, endoscopic sphincterotomy has better clinical efficacy and lower incidence rate of complications. It is easily operated and has minimal invasion, which is worthy of clinical application.