探讨单孔腹腔镜胆囊切除术（LC）联合腹腔镜胆总管探查术（LCBDE）、胆道支架置入一期缝合治疗胆囊结石合并胆总管结石的安全性和效果。

回顾性分析2024年11月至2025年3月在成都市第二人民医院接受单孔LC联合LCBDE、胆道支架置入一期缝合的18例胆囊结石合并胆总管结石患者临床资料。患者均签署知情同意书，符合医学伦理学规定。其中男4例，女14例；年龄（54±21）岁；合并胰腺炎2例，合并糖尿病1例；BMI 19.3~33.2 kg/m²，中位数23.5 kg/m²。观察患者手术时间、术中出血量、术后并发症、住院时间及随访结果。为评估手术技术的学习曲线，将18例患者按手术时间顺序分为前9例和后9例两组，两组手术时间比较采用t检验。

18例患者均顺利完成手术，无中转开腹病例。手术时间为（131±31） min，术中出血量（24±8） ml。胆总管直径10（8~23） mm； 结石最大径6（3~21） mm；结石数量2（1~12）枚。11例患者放置腹腔引流管，其余7例未放置。前9例和后9例的手术时间分别为（143±31）、（119±28） min，差异无统计学意义（t=1.723，P=0.104）。所有患者术后恢复良好，术后1~2 d开始进食流质，2~3 d肛门排气。无围手术期死亡，无切口感染、胆道狭窄、残余结石、胆漏等严重并发症发生。患者住院时间为9（6~10）d。术后1个月复诊，所有支架均自行脱落，未见残余结石、胆管狭窄等并发症。所有患者均恢复正常工作和生活。

对于胆囊结石合并胆总管结石患者，单孔LC联合LCBDE、胆道支架置入一期缝合是一种安全、有效的微创手术方式，不仅能同时解决胆囊和胆总管结石问题，还具有创伤小、恢复快、美容效果佳等优势。

To evaluate the safety and efficacy of single-port laparoscopic cholecystectomy (LC) combined with laparoscopic common bile duct exploration (LCBDE) and biliary stent implantation and primary suture in the treatment of cholecystolithiasis complicated with common bile duct stones.

Clinical data of 18 patients with cholecystolithiasis and common bile duct stones who underwent single-port LC combined with LCBDE and biliary stent implantation and primary suture in Chengdu Second People's Hospital from November 2024 to March 2025 were retrospectively analyzed. The informed consents of all patients were obtained and the local ethical committee approval was received. Among them, 4 patients were male and 14 female, aged (54±21) years. 2 cases were complicated with pancreatitis and 1 case complicated with diabetes. Body mass index (BMI) was ranged from 19.3 to 33.2 kg/m², with a median of 23.5 kg/m². The operation time, intraoperative blood loss, postoperative complications, the length of hospital stay and follow-up outcomes were observed. To evaluate the learning curve of surgical technologies, 18 patients were divided into group A (n=9) and B (n=9) according to the date of surgery. The operation time between two groups was compared by t-test.

All 18 patients successfully completed the surgery without conversion to open surgery. The operation time was (131±31) min. Intraoperative blood loss was (24±8) ml. The diameter of common bile duct was 10 (8-23) mm. The maximum diameter of the stones was 6 (3-21) mm. The number of stones was 2 (1-12). Abdominal drainage catheter was placed in 11 out of 18 patients. The operation time in group A and B was (143±31) and (119±28) min, with no statistical significance (t=723, P=0.104). All patients were recovered well after surgery, and began to receive liquid diet at postoperative 1-2 d. The time to first flatus was 2-3 d after surgery. No perioperative death, incisional infection, biliary stricture, residual stone and bile leakage occurred. The length of hospital stay was 9 (6-10) d. During follow-up at postoperative 1 month showed that all stents fell off spontaneously. No residual stones, bile duct stenosis or other complications were found. All patients restored normal work and life.

Single-port LC combined with LCBDE and biliary stent implantation and primary suture is a safe and effective minimally invasive surgical procedure for patients with cholecystolithiasis and common bile duct stones, which can not only treat cholecystolithiasis and common bile duct stones, but also has multiple advantages of mild trauma, rapid recovery and favorable cosmetic effect.