探究数字化微创技术对复杂性肝胆管结石患者胆道、肝静脉、门静脉的解剖分型辨认及临床应用效果。

回顾性选取2019年1月至2022年4月收治的基于数字化微创技术行肝切除术治疗的复杂性肝胆管结石患者30例作为研究组，另选择同期基于传统医学影像检查行腹腔镜肝切除术治疗的复杂性肝胆管结石患者30例作为对照组。采用SPSS 24.0完成数据分析。胆道、肝静脉、门静脉分型、术后并发症、结石残留和复发情况等计数资料采用[n（%）]表示，组间比较行χ²检验；围手术期指标、肝功能指标等计量资料采用（Mean±SD）表示，组间比较行独立t检验。P<0.05为差异有统计学意义。

研究组术前检查所见胆道、肝静脉及门静脉分型与术中所见符合率分别为96.7%、100.0%、100.0%，显著高于对照组的73.3%、76.7%、73.3%（P<0.05）；研究组患者手术时间和术后住院时间显著短于对照组，术中出血量和输血量显著少于对照组（P<0.05）；两组患者术后1个月ALT、AST、ALP、TBil水平较术前显著降低，且研究组明显低于对照组（P<0.05）；研究组并发症总发生率明显低于对照组（6.7% vs. 26.7%，P<0.05），两组患者结石残留率和复发率比较，差异无统计学意义（P>0.05）。

复杂性肝胆管结石患者应用数字化微创技术指导治疗，可在术前精准辨析肝内胆管及脉管解剖与变异情况，相比传统手术治疗，明显减少了手术时间及术中出血量，可最大限度保护肝脏及其功能，减少术后并发症，加快患者恢复进程。

To explore the anatomical classification and clinical application effect of digital minimally invasive technique on biliary tract, hepatic vein and portal vein in patients with complex hepatolithiasis.

Thirty patients with complex hepatolithiasis who underwent hepatectomy based on digital minimally invasive technology from January 2019 to April 2022 were retrospectively selected as the study group, and another 30 patients with complex hepatolithiasis who underwent laparoscopic hepatectomy based on traditional medical imaging during the same period were selected as the control group. SPSS 24.0 was used to complete the data analysis. The classification of biliary tract, hepatic vein, portal vein, postoperative complications, stone residue and recurrence were represented by [n (%)]. χ² test was performed for comparison between groups. Measurement data such as perioperative indexes and liver function indexes were represented by (Mean±SD), and independent t test was performed between groups. P<0.05 was considered statistically significant.

The coincidence rates of preoperative biliary tract, hepatic vein and portal vein were 96.7%, 100.0% and 100.0%, respectively, which were significantly higher than that of control group (73.3%, 76.7% and 73.3%, P<0.05). The operation time and postoperative hospital stay in the study group were significantly shorter than those in the control group, and the amount of intraoperative blood loss and blood transfusion was significantly less than that in the control group (P<0.05). The levels of ALT, AST, ALP and TBil in two groups were significantly lower than before surgery one month after surgery, and the study group was significantly lower than the control group (P<0.05). The total complication rate of the study group was significantly lower than that of the control group (6.7% vs. 26.7%, P<0.05), and there was no significant difference in stone residual rate and recurrence rate between the two groups (P>0.05).

The application of digital minimally invasive technology to guide the treatment of patients with complex hepatolithiasis can accurately distinguish the intrahepatic bile duct and vascular anatomy and variation before surgery. Compared with traditional surgical treatment, the operation time and intraoperative blood loss are significantly reduced, which can protect the liver and its function to the maximum extent, reduce postoperative complications, and accelerate the recovery process of patients.