Abstract: Objective To comparatively analyze the effects of laparoscopic and open left hepatectomy on intrahepatic bile duct stones. Methods Ninety-one patients with intrahepatic bile duct stones were divided into observation group (48 cases) and control group (43 cases) according to different surgical methods. The patients in observation group underwent laparoscopic left hepatectomy and the patients in control group underwent traditional open left hepatectomy. The intraoperative conditions (operation time, intraoperative blood loss), postoperative conditions (postoperative exhaust time, postoperative time of leaving bed, postoperative hospitalization time), postoperative complications (pneumonia, incision infection, bile leakage, abdominal bleeding), residual stones and recurrence of stones of two groups were compared. Results The operation time of patients in observation group was significantly longer than control group (P<0.05); While the postoperative exhaust time, postoperative time of leaving bed and postoperative hospital stay of were significantly shorter (P<0.05). There was no significant difference in intraoperative blood loss, the incidence of postoperative complications, the residual stone rate, and the recurrence rate between two groups (P>0.05). Conclusion Treating intrahepatic bile duct stones with laparoscopic left hepatectomy has the advantages of less trauma and rapid postoperative recovery, and is worthy of popularization and application in hospitals with conditions.

Key words: intrahepatic bile duct stones, laparoscopy, hepatectomy

摘要： 目的 对比分析腹腔镜与开腹左半肝切除治疗肝内胆管结石的效果。方法 91例肝内胆管结石患者按手术方式不同分为观察组48例和对照组43例,观察组患者行腹腔镜下左半肝切除术,对照组行传统开腹左半肝切除术。对比两组患者术中情况（手术时间、术中出血量）、术后情况（术后排气时间、术后离床时间、术后住院时间）、术后并发症（肺炎、切口感染、胆漏、腹腔出血）、结石残留和结石复发情况。结果 观察组患者手术时间明显长于对照组,术后排气时间、术后离床时间、术后住院时间明显短于对照组,差异具有统计学意义（P<0.05）。两组患者术中出血量、术后并发症发生率、结石残留率、结石复发率比较,差异无统计学意义（P>0.05）。结论 腹腔镜左半肝切除治疗肝内胆管结石具有创伤小、术后恢复快的优势,值得有条件的医院推广应用。

关键词: 肝内胆管结石, 腹腔镜, 肝切除