目的 探讨腹腔镜联合胆道镜保胆取石术的临床价值。方法 回顾性分析我院2009年2月至2010年2月期间95例腹腔镜联合胆道镜保胆取石术患者的临床资料。结果 95例患者均顺利完成保胆取石术，平均手术时间49 min，术中平均出血量9 ml，除8例发生切口脂肪液化外无其他手术并发症发生，1年内随访无复发。结论 在严格掌握适应证的前提下，对胆囊结石患者有选择性地采用腹腔镜联合胆道镜保胆取石术，是一种可供选择的安全的微创治疗方法。
Objective To analyze clinicopathologic characteristics of 1 008 patients with gallbladder polyps by minimally invasive gallbladder-preserving surgery, and to explore hemostatic effect of 0–4 ℃ cold saline plus different concentrations norepinephrines in flushing gallbladder mucosa bleeding. Methods The clinical data of 1 008 patients with gallbladder polyps by the minimally invasive gallbladder-preserving surgery from 2009 to 2016 in the General Hospital of Xinjiang Military Command were retrospectively analyzed. The clinicopathologic types of gallbladder polyps and the relationship between the operation time and the recurrence of gallbladder polyps were analyzed, the hemostatic effects of 0–4 ℃ cold saline plus different concentrations (0, 16, 24, and 30 mg/L) norepinephrines in flushing gallbladder mucosa bleeding (The hemostatic effect was reflected by the time of flushing gallbladder mucosa bleeding) were compared. Results One thousand patients with non-tumorous gallbladder polyps successfully underwent the minimally invasive gallbladder-preserving surgery, another 8 cases patients with tumorous gallbladder polyps underwent the cholecystectomy immediately. There were 128 cases of single polyps and 880 cases of multiple polyps. The polyp diameters of 910 cases were 5–10 mm and 98 cases were 10–15 mm. The pathological analysis indicated that there were 912 (90.5%) cases of the cholesterol polyps, 74 (7.3%) cases of the inflammatory polyps, 14 (1.4%) cases of the adenoid hyperplasia, and 8 (0.8%) cases of the neoplastic polyps ［adenoma 6 cases, adenocarcinoma (T0N0M0) 2 cases］. The gallbladder polyps recurrences were found in 30 (3.0%) cases during 1–8 years of follow-up (average 4 years), all of them were the multiple and cholesterol polyps. The flushing gallbladder mucosa bleeding time of 0–4 ℃ cold saline plus 0, 16, 24, and 30 mg/L concentraions norepinephrine was (44±5) min, (33±6) min, (17±5) min, and (17±4) min in the 125, 230, 555, and 98 patients with gallbladder polyps, respectively. The time of flushing gallbladder mucosa bleeding between the other concentration groups had significant difference (P<0.05) except for between the 24 mg/L concentration group and the 30 mg/L concentration group (P>0.05). The operation time was (62±21) min and (60±19) min of the 30 patients with gallbladder polyps recurrence and the 970 patients without gallbladder polyps recurrence, which had no significant difference (P>0.05). Conclusions Cholesterol polyp is a common pathological type of gallbladder polyp, inflammatory polyp and adenomyosis polyp are uncommon, and multiple polyps are common. Hemostatic effects of 0–4 ℃ cold saline plus different concentraions norepinephrine in flushing gallbladder mucosa bleeding are desirable, expecially at a 24 mg/L concentraion norepinephrine is the most effective. No correlation is found between operation time and recurrence of gallbladder polyp.