腹腔镜胆囊切除术中胆总管被牵拉成角是导致医疗性胆管损伤常见原因之一。胆总管活动度是指其左右方向摆动和上下方向伸展的柔韧度。笔者在长期临床实践中发现，胆总管可分为固定型和松弛型2种类型，前者缺乏活动度，难以牵拉成角；后者具有一定活动度，易被牵拉成角，错误施夹离断造成胆总管损伤。高度警惕活动度较大的松弛型胆总管，对预防医疗性胆管损伤，保障手术安全性具有重要临床意义。

Angulation of the common bile duct caused by traction during laparoscopic cholecystectomy is one of the leading causes of iatrogenic bile duct injury. The mobility of the common bile duct refers to its flexibility for lateral swing and vertical stretching. Based on long-term clinical experience, the author classifies the common bile duct into two types: fixed type and lax type. The fixed type has poor mobility and is not prone to traction-induced angulation. In contrast, the lax type possesses considerable mobility and is easily angulated under traction, which may lead to common bile duct injury due to improper clipping and transection. Close vigilance against the lax common bile duct with high mobility is of great clinical significance for preventing iatrogenic bile duct injury and ensuring surgical safety.