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目的:比较腹腔镜和开腹胆囊癌根治术的近期临床疗效及远期预后。方法:回顾性分析2010年1月至2020年12月于浙江省人民医院肝胆胰外科接受胆囊癌根治术的133例胆囊癌患者的临床及术后随访资料。其中80例完成腹腔镜胆囊癌根治术（腹腔镜组），男性23例，女性57例，年龄［n M（IQR）］66.0（12.8）岁（范围：28.0~82.0岁）；53例完成开腹胆囊癌根治术（开腹组），男性8例，女性45例，年龄63.0（6.0）岁（范围：45.0~80.0岁）。腹腔镜组与开腹组在年龄、性别、体重指数、术前白蛋白、术前总胆红素、N分期、脉管侵犯、神经侵犯及肿瘤分化的差异均无统计学意义（n P值均>0.05），而术前CA19-9（n Z=-2.955，n P=0.003）、术前ALT水平（n Z=-2.801，n P=0.031）、T分期分布（χn 2=19.110，n P=0.007）的差异均有统计学意义。定量资料的比较采用非参数检验，分类资料的比较采用χn 2检验或Fisher确切概率法。n 结果:两组患者在手术时间、淋巴结清扫数目、阳性淋巴结数目、术中胆囊破裂，术后胆瘘、腹腔出血、腹腔感染发生率，术后30 d和90 d病死率、切口种植及术后腹腔转移方面的差异均无统计学意义（n P值均>0.05）；腹腔镜组术中出血量［100.0（200.0）ml比400.0（250.0）ml］（n Z=-5.260，n P0.05). But there were significant differences in preoperative CA19-9(n Z=-2.955, n P=0.003), preoperative ALT level(n Z=-2.801,n P=0.031) and T stage (χn 2=19.110,n P=0.007) between the two groups. A non-parametric test was used for quantitative data. χn 2 test or Fisher exact probability method was used for count data.n Results:Patients in the laparoscopic group did not differ from those in the laparotomy group in terms of length of operation,number of lymph node yield,number of positive lymph nodes,the incidence of intraoperative gallbladder rupture,incidence of postoperative bile leakage,abdominal bleeding or abdominal infection,30-day mortality,90-day mortality, the incidence of incision implantation or peritoneal cavity metastasis(all n P>0.05). Patients in the laparoscopic group showed less intraoperative bleeding(100.0(200.0)mln vs. 400.0(250.0)ml)(n Z=-5.260,n P<0.01),fewer days with drainage tube indwelling(6.0(3.8)daysn vs. 7.0(4.0)days)(n Z=-3.351, n P=0.009), and fewer postoperative days in hospital(8.0(5.0)daysn vs. 14.0(7.5)days)(n Z=-6.079,n P<0.01) than those in the laparotomy group. Patients in the laparoscopic group displayed better overall survival (n P<0.01) and progression-free survival (n P0.05).n Conclusions:Laparoscopic radical resection can achieve long-term survival for GBC comparable to that with open surgery. Laparoscopic radical resection has advantages over open surgery regarding surgical trauma and postoperative recovery.