目的:探讨胆总管结石腹腔镜胆总管探查术后三种胆管闭合方法的临床价值。方法:选取2011年1月至2018年1月山东省滕州市中心人民医院肝胆外科收治的183例接受腹腔镜胆总管探查术的胆总管结石患者，男113例，女70例，年龄(51.20±6.79)岁，年龄范围为43～65岁，根据术后闭合方法分为三组，分别行T管引流、J管引流及一期缝合处理，并观察三组患者术前基线资料、手术时间、术中出血量、术后补液量、引流管拔除时间、胃肠通气时间、术后住院时间和术后胆道相关并发症。结果:三组患者性别、年龄、胆总管直径、胆总管内结石数量、总胆红素、直接胆红素等术前基线资料比较，差异均无统计学意义(n P>0.05)；三组术中出血量、引流管拔除时间、胃肠通气时间比较，差异均无统计学意义(n P>0.05)；一期缝合组手术时间[(93.65±12.83)min]、术后补液量[(5.38±0.93)L]、术后住院时间[(5.85±1.74)d]均低于T管引流组[(115.34±13.85)min、(10.85±1.25)L、(10.83±3.47)d]和J管引流组[(119.32±15.42)min、(10.63±1.48)L、(10.25±3.69)d]，差异有统计学意义(n P0.05)；三组残留结石、胆道狭窄、术后出血等并发症发生率比较，差异均无统计学意义(n P>0.05)，J管引流组胆漏发生率低于T管引流组和一期缝合组，但差异无统计学意义(n P>0.05)。n 结论:与胆总管结石腹腔镜胆总管探查术后T管置管引流相比较，一期缝合有利于减少手术创伤和缩短住院时间，而定期自行脱落单J管引流则有减少胆漏的趋势，值得进一步探讨。“,”Objective:To investigate the clinical value of three methods of bile duct closure after laparoscopic common bile duct exploration for choledocholithiasis.Methods:A retrospective study was performed on 183 cases of patients with choledocholithiasis who were admitted from January 2011 to January 2018.There were 113 male and 70 female, aged(51.20±6.79)years old, the age range was 43 to 65 years old.According to the postoperative close method, patients were divided into three groups, respectively, T tube drainage, J tube drainage and issue of stitching.The three groups of patients with preoperative baseline data, operation time, intraoperative blood loss, postoperative rehydration capacity, drainage tube removal time, gastrointestinal ventilation time, postoperative hospital stay and postoperative biliary complications were observed.Results:There were no statistically significant differences in the preoperative baseline data of gender, age, diameter of common bile duct, number of common bile duct stones, total bilirubin and direct bilirubin in the three groups(n P>0.05). There were no statistically significant differences in intraoperative blood loss, drainage tube removal time and gastrointestinal ventilation time between the three groups(n P>0.05). The operation time [(93.65±12.83)minutes], postoperative fluid supplementation [(5.38±0.93)L], postoperative hospital stay [(5.85±1.74)days] in the primary suture group were all lower than that in the T-tube drainage group [(115.34±13.85)minutes, (10.85±1.25)L, (10.83±3.47)days] and the J tube drainage group [(119.32±15.42)minutes, (10.63±1.48)L, (10.25±3.69)days], the differences were statistically significant(n P0.05). The incidence of residual stones, biliary stricture, postoperative bleeding and other complications in the three groups was not significantly different(n P>0.05). The incidence of bile leakage in the J-tube drainage group was lower than that in the T-tube drainage group and the first-stage suture group, but the difference was not statistically significant(n P>0.05).n Conclusion:Compared with T-tube drainage after laparoscopic choledocholithiasis laparoscopic choledocholithiasis, one-stage suture is beneficial to reduce surgical trauma and shorten hospitalization time, while regular self-removal of single J-tube drainage tends to reduce bile leakage, which is worthy of further discussion.