关键词: 胆囊结石, 胆总管结石, 经胆囊管胆总管探查取石术（LTCBDE）, 三镜联合, 胆囊管途径

Abstract: Objective To compare the clinical efficacy of laparoscopic cholecystectomy combined with duodenoscopic， laparoscopic， and choledochoscopic common bile duct exploration （Tri-scope） and laparoscopic transcystic common bile duct exploration （LTCBDE）for the treatment of cholecystolithiasis with common bile duct stones. Methods108 patients with cholecystolithiasis and common bile duct stones whose choledocholithiasis diameter was less than 1 cm were analyzed in Wuhan Fourth Hospital from January 2018 to July 2023，including 48 cases treated with LTCBDE （observation group） and 60 cases treated with Tri-scope （control group）. The two groups were compared in terms of operation time，postoperative hospital stay，gastrointestinal recovery time，time to remove the abdominal drainage tube，residual stone rate，and postoperative complication rate.ResultsThere was no statistically significant different in the base line data between the two groups of patients, and they were comparable. The operation time in the observation and control groups was （108. 92 ± 13. 69） minutes and （129. 5 ± 17. 17） minutes， the postoperative hospitalization time was（6. 79 ± 1. 74）days and（8. 30 ± 1. 46）days，the postoperative extubation time was （3. 65 ± 0. 64） days and （4. 92 ± 1. 14） days，the postoperative exhaust time was （2. 31 ± 0. 69） days and （3. 32 ± 0. 79） days，with statistically significant differences between the two groups （P < 0. 05）. There was no statistically significant difference between the two groups in terms of surgical success rate， stone removal rate，and stone recurrence rate（P > 0. 05）. No complications occurred in the obserration group while 6 complications occurred in the control group， there was no statistically significant difference（P > 0. 05）. Conclusion LTCBDE is safe and effective for smaller choledochal stones with short operative time and quick postoperative recovery.

Key words: cholecystolithiasis, common bile duct stones, laparoscopic transcystic common bile duct exploration（LTCBDE）, Tri-scope；transcystic