【摘要】目的：探讨复杂性肝胆管结石患者采用腹腔镜联合胆道镜取石术治疗的效果及对其手术指标及T淋巴细胞亚群水平的影响。方法：选择我院在2022年1月—2022年12月接收并实施手术治疗的60例复杂性肝胆管结石患者，按照随机数字表法将患者分为观察组(腹腔镜联合胆道镜取石术)和对照组(开放手术)，每组30例，比较两组患者临床治疗效果、手术指标及T淋巴细胞亚群水平。结果：观察组有效率为96.7%，略高于对照组的93.3%，但差异无统计学意义(P>0.05)。观察组手术时间长于对照组，术中出血量少于对照组，引流时间短于对照组(P<0.05)。术后3d，观察组CD4+及CD4+/ CD8+高于对照组，CD8+低于对照组(P<0.05)。结论：为复杂性肝胆管结石患者应用腹腔镜联合胆道镜取石术实施治疗，可保障临床疗效，减少术中的出血量，缩短引流时间，保持T淋巴细胞亚群水平的稳定。

    【关键词】腹腔镜；胆道镜取石术；复杂性肝胆管结石；手术指标；T淋巴细胞亚群水平

    The effect of laparoscopic combined with choledochoscopic lithotomy in the treatment of complex hepatolithiasis patients and its impact on surgical indexes and the levels of T lymphocyte subsets

    YANG Xiaojin， HUA Fu， LI Jie， CHEN Weijun

    Department 1 of General Surgery， Jiangsu， Dongtai People’s Hospital， Yancheng， Jiangsu 224200， China

    【Abstract】Objective：To investigate the effectiveness of laparoscopic combined with choledochoscopic lithotomy in the treatment of patients with complex hepatolithiasis and its impact on surgical indicators and T lymphocyte subsets.Methods：Sixty patients with complex hepatolithiasis who received and underwent surgical treatment in our hospital from January 2022 to December 2022 were selected and divided into the observation group (laparoscopic combined with choledochoscopic lithotomy) and the control group (open surgery) according to the random number table method ......