目的 探讨腹腔镜联合内镜治疗对肝胆结石性疾病者围手术期指标及炎性因子的影响。方法 回顾性分析2020年1月—2024年12月福建省三明市第一医院收治的90例肝胆结石性疾病患者的临床资料,按照手术方式的差异分为研究组（60例,实施腹腔镜结合内镜手术治疗）和对照组（30例,实施传统开腹手术治疗）,比较两组围手术期指标（手术时间、术中出血量、术后排气时间、住院时间）,炎性因子C-反应蛋白（CRP）、肿瘤坏死因子-α（TNF-α）和肝功能指标丙氨酸转氨酶（ALT）、天冬氨酸转氨酶（AST）、总胆红素（TBil）、γ-谷氨酰转移酶（GGT）变化。结果 与对照组比较,研究组术中出血量更少,手术时间、术后排气时间、住院时间更短,炎性因子水平更低,肝功能指标更低,并发症发生率更低,差异均有统计学意义（P<0.05）。结论 应用腹腔镜联合内镜治疗肝胆结石性疾病可减少术中出血量,缩短手术时间、排气时间和住院时间,有效降低炎性因子水平,改善肝功能,且安全性较高。

Objective To explore the effects of laparoscopy combined with endoscopy on perioperative indicators and inflammatory factors in patients with hepatobiliary calculous diseases. Methods A retrospective analysis was conducted on the clinical data of 90 patients with hepatobiliary calculi diseases admitted to the First Hospital of Sanming City, Fujian Province from January 2020 to December 2024. According to surgical methods, they were divided into a study group （60 cases, treated with laparoscopic combined with endoscopic surgery） and a control group （30 cases, treated with traditional open surgery）. Comparisons between the two groups included perioperative indicators （operation time, intraoperative blood loss volume, postoperative exhaust time, and length of hospital stay）, inflammatory factors C-reactive protein （CRP）, and tumor necrosis factor-α （TNF-α）, and changes in liver function indicators alanine transaminase （ALT）, aspartate transaminase （AST）, total bilirubin （TBil）, and γ-glutamyl transferase （GGT）. Results Compared with the control group, the study group had less intraoperative blood loss, shorter operation time, postoperative exhaust time, and hospital stay, and lower inflammatory factors, liver function levels, and incidence of complications; all differences were statistically significant （P<0.05）. Conclusion The application of laparoscopy combined with endoscopy in the treatment of hepatobiliary calculous diseases has a remarkable therapeutic effect. It reduces intraoperative blood loss, shortens operation time, exhaust time, and hospital stay, effectively lowers the levels of inflammatory factors, improves liver function, and shows a high safety.