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中华肝脏外科手术学电子杂志

中华肝脏外科手术学电子杂志 ›› 2026, Vol. 15 ›› Issue (05) : 692 -701. doi: 10.3877/cma.j.issn.2095-3232.2026.05.003

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胆总管结石合并胆囊结石的腹腔镜、胆道镜及内镜联合治疗进展
刘立民1,2, 张宗明1,2,†(), 刘卓1,2   
  1. 1　100073　北京，国家电网公司北京电力医院普通外科
    2　100073　北京，中国通用技术集团肝胆疾病临床医学研究中心（筹）
  • 收稿日期:2026-04-22 出版日期:2026-10-10
  • 通信作者: 张宗明
  • 基金资助:
    北京市科技重大专项生物医药与生命科学创新培育研究(Z171100000417056); 国中康健集团科技项目(GZKJ-KJXX-QTHT-20240429)

Advances in combined laparoscopic, choledochoscopic, and endoscopic treatment of concomitant choledocholithiasis and cholecystolithiasis

Limin Liu1,2, Zongming Zhang1,2,†(), Zhuo Liu1,2   

  1. 1 Department of General Surgery, Beijing Electric Power Hospital, State Grid Corporation of China, Beijing 100073, China
    2 Clinical Research Center for Hepatobiliary Diseases (in preparation), China General Technology Group, Beijing 100073, China
  • Received:2026-04-22 Published:2026-10-10
  • Corresponding author: Zongming Zhang
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刘立民, 张宗明, 刘卓. 胆总管结石合并胆囊结石的腹腔镜、胆道镜及内镜联合治疗进展[J/OL]. 中华肝脏外科手术学电子杂志, 2026, 15(05): 692-701.

Limin Liu, Zongming Zhang, Zhuo Liu. Advances in combined laparoscopic, choledochoscopic, and endoscopic treatment of concomitant choledocholithiasis and cholecystolithiasis[J/OL]. Chinese Journal of Hepatic Surgery(Electronic Edition), 2026, 15(05): 692-701.

胆石症作为全球高发的消化系统疾病，其治疗策略的演变深刻反映了微创外科理念与技术的持续进步。胆囊结石与胆总管结石共存时，显著增加了临床处理的复杂度。传统开腹手术虽能通过一次性胆总管探查取石实现确切疗效，但存在手术创伤大、术后恢复慢、并发症发生率高等弊端。随着微创外科理念的深化与技术迭代，以腹腔镜、胆道镜和内镜为核心的多镜联合治疗方案，通过整合各自技术优势，正在重构复杂胆石症的临床治疗路径，充分彰显了微创外科在结石清除效率、解剖精准度及患者康复质量方面的综合优势。本文系统梳理当前主流微创联合术式的临床应用进展，为胆囊结石合并胆总管结石的优化治疗提供理论参考。

关键词: 胆囊结石, 胆总管结石, 腹腔镜, 胆道镜, 内镜逆行胰胆管造影术, 微创外科

Cholelithiasis is a highly prevalent digestive system disease worldwide, and the evolution of its treatment strategies profoundly reflects the continuous advancement of minimally invasive surgical concepts and techniques. The coexistence of gallbladder stones and common bile duct stones significantly increases the complexity of clinical management. Although conventional open surgery can achieve definitive therapeutic efficacy through single-stage common bile duct exploration and stone removal, it has disadvantages including substantial surgical trauma, slow postoperative recovery, and a high incidence of complications. With the continued development of minimally invasive surgical concepts and technological advances, combined multi-endoscopic treatment strategies centered on laparoscopy, choledochoscopy, and endoscopy are reshaping the clinical treatment pathway for complex cholelithiasis by integrating the respective advantages of these techniques. These strategies fully demonstrate the comprehensive advantages of minimally invasive surgery in terms of stone clearance efficiency, anatomical precision, and quality of patient recovery. This article systematically reviews recent advances in the clinical application of mainstream combined minimally invasive procedures, providing a theoretical reference for optimizing the treatment of concomitant gallbladder stones and common bile duct stones.

Key words: Cholecystolithiasis, Common bile duct stones, Laparoscopy, Choledochoscopy, Endoscopic retrograde cholangiopancreatography (ERCP), Minimally invasive surgery
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