比较腹腔镜和开腹手术对复发性肝胆管结石患者术后肝功能和预后的影响。

回顾性分析2013年1月至2017年12月67例有胆道手术史的复发性肝胆管结石患者资料，根据不同术式将患者分为腔镜组(35例)和开腹组(32例)。运用SPSS20.0软件进行统计学分析，手术相关指标等计量资料以(±s)表示，独立t检验；术后并发症发生率采用χ²检验，以P<0.05为差异有统计学意义。

腔镜组手术时间长于开腹组，而术中出血量、术后住院时间和肝功能恢复时间均少于开腹组，两组差异均有统计学意义(P<0.05)；两组ALT、AST、TBIL平均水平较术前均下降(P<0.05)，且两组间比较无统计学差异(P>0.05)。腔镜组术后并发症发生率为8.6%，显著低于开腹组的31.3%，差异有统计学意义(P<0.05)。

腹腔镜肝切除联合胆道镜用于治疗复发性肝胆管结石安全可靠，值得临床进行推广与应用。

To compare the effect of laparoscopic hepatectomy combined with choledochoscopy and open surgery on postoperative liver function and prognosis in patients with recurrent hepatolithiasis.

67 cases of patients who had a history of biliary surgery with recurrent hepatolithiasis from January 2013 to December 2017 were selected as the observation objects. They were divided into laparoscopic group (35 cases received laparoscopic surgery) and open group (32 cases received open surgery) according to the different operation methods. Research data were analyzed by SPSS 20.0 software. The measurement data were expressed as (±s) and were compared by t test while other enumeration data such as incidence of postoperative complications were compared by chi square test. P<0.05 was regarded to be statistically significant.

The operation time in laparoscopic group was longer (P<0.05), the intraoperative blood loss, the length of hospitalization and the recovery time of liver function in laparoscopic group were less than those of open group (P<0.05). The mean levels of ALT, AST and TBIL in both groups were lower than those of before operation (P<0.05), and there was no statistical difference between the two groups(P>0.05). The rate of postoperative complications of laparoscopic group was 8.6%, which were less than that of open group 31.3%, and the difference was statistically significant (P<0.05).

Laparoscopic hepatectomy combined with choledochoscopy for hepatolithiasis is safe and reliable, and it deserves promotion and application.