目的    探讨腹腔镜下胆道镜经胆囊管胆道探查取石术治疗胆总管小结石的临床疗效和安全性。方法2009年8月至2012年8月昆明医科大学第二附属医院肝胆胰外三科共为68例胆囊结石合并胆总管小结石病人行腹腔镜下胆道镜经胆囊管胆道探查取石术，观察其临床效果。结果    68例中62例顺利完成手术，手术成功率为91.1%，平均手术时间86 min，6例改行腹腔镜下胆总管切开探查取石术，其中4例行胆总管一期缝合，2例行T管引流术，中转率为8.9%。所有病人均放置腹腔引流管，术后2～6 d拔除，术后平均住院时间6 d。无胆漏、结石残留、胆道感染、胆道出血等并发症发生。结论    腹腔镜下胆道镜经胆囊管胆道探查取石术具有创伤小、并发症少、恢复快、费用低、安全等优点，是理想的胆总管探查取石术式，但应严格掌握其适应证。

Laparoscopic transcystic common bile duct exploration：A clinical analysis of 68 cases        SUN Min，LIU Xun-qiang，TENG Yi-shan et al. Department of Hepatopancreatobiliary Surgery 3, the 2nd Affiliated Hospital of Kunming Medical University，Kunming 650101, China
Corresponding author： TENG Yi-shan，E-mail：liuxunqiang1001@163.com
Abstract    Objective    To explore the curative effect and safety of laparoscopic transcystic common bile duct exploration in treating the small stones in common bile duct. Methods    A total of 68 cases of laparoscopic transcystic common bile duct exploration were performed from August 2009 to August 2012 in Department of Hepatopancreatobiliary Surgery 3, the 2nd Affiliated Hospital of Kunming Medical University. The therapeutic effects of cases were studied. Results    Among them, 62 cases were performed operation successfully. The success rate of operation was 91.12%. The mean operation time was 86 minute. Six cases were changed to laparoscopic common bile duct incision exploratory stone operation. Four cases were performed laparoscopic common bile duct exploration and primary suture, and 2 cases were performed T tube drainage. The transfer rate was 8.88%. All cases were placed abdominal cavity drainage tube pulled out after 2-6 days. The average hospitalization time was 6 days. No bile leak, stone residue, biliary tract infection, biliary tract bleeding complications occurred. Conclusion    Laparoscopic transcystic common bile duct exploration has many advantages such as small trauma, short time，less complications, quick recovery，safe，low cost, safety and effective, etc. It is the ideal common bile duct exploration and stone operation. But its indications must be grasped strictly.