探讨3D腹腔镜胆囊切除联合胆总管探查取石术的治疗效果。

回顾性分析2016年1月至2017年10月接受腹腔镜胆囊切除＋胆总管探查手术治疗的胆道结石患者68例，按照手术方法分为3D腹腔镜组(3D组)和2D腹腔镜组(2D组)，采用SPSS20.0软件进行统计学分析。两组患者手术相关指标及术后3个月术后生活质量等计量资料以(±s)表示，采用独立t检验；术后并发症发生率及随访情况等计数资料以例(%)表示，组间比较采用χ²检验，P<0.05为差异有统计学意义。

与2D组相比，3D组患者手术时间及出血量均明显减少(P<0.05)，两组在术后引流时间、平均住院时间、住院费用、术后并发生总发生率等方面差异无统计学意义(P>0.05)。随访3～12个月，2D组有1例患者出现结石复发，3D组无结石残留病例；术后3个月生存质量水平3D组显著优于2D组(P<0.05)。

3D腹腔镜技术提高了腹腔镜胆囊切除术联合胆总管探查取石术的成功率，有助于手术操作的精确，缩短了手术时间，降低术中出血量且不增加并发症发生率，提高了术后生活质量，值得在临床中推广使用。

To evaluate the effect of 3D laparoscopic cholecystectomy combined with choledocholithotomy.

From 2016 January to 2017 October, 68 cases of cholelithiasis were selected and treated with laparoscopic cholecystectomy plus common bile duct exploration in our hospital. According to the operation method, the patients were divided into two groups: 3D laparoscopic group (3D group) and 2D laparoscopic group (2D group). Clinical data of the two groups were analyzed by SPSS20.0 software. The related indexes of operation and 3 months after operation in both groups were analyzed. The quantitative data such as the quality of Life scale (QOL) were expressed as (±s) and compared with independent t test, the incidence of postoperative complications and follow-up data were expressed in the number of cases and compared with chi square. A P<0.05 was considered as significant difference.

Compared with 2D group, the operation time and bleeding volume in 3D group were significantly reduced (P<0.05). There were no significant difference in postoperative drainage time, average hospitalization time, hospitalization cost and the incidence of postoperative complications. There was no significant difference in 3~12 months follow-up, 1 patient in 2D group with recurrence of stone was found and no residual stone in 3D group was found. 3 months after operation, the quality of life in 3D group was significantly better than that in 2D group.

The success rate of laparoscopic cholecystectomy plus common bile duct exploration was improved by 3D laparoscopic technique. It can be helpful to the accuracy of the operation, shorten the operation time, reduce the amount of intraoperative bleeding and does not increase the incidence of complications, which is worth popularizing in clinic.