目的 探讨数字智能化诊疗技术在多次胆道手术史肝胆管结石病诊疗中的应用价值。 方法 采用回顾性队列研究方法，纳入2017年1月至2024年12月南方医科大学珠江医院行胆道镜联合硬镜取石手术治疗的合并胆道手术史的肝胆管结石病患者，分为3DVT-FI组和常规手术组。收集、分析和比较两组临床数据。 结果 共纳入63例患者，其中3DVT-FI组33例，常规手术组30例。逆概率加权（inverse probability of treatment weighting， IPTW）后一般资料均差异无统计学意义（P > 0.05）。3DVT-FI组的开腹率、术中出血量、术后并发症发生率以及3月内再次手术发生率显著低于常规手术组（均P < 0.05）。单因素分析显示术后有和无并发症患者在是否合并肝外胆管结石、手术年份、以及手术方案存在差异（P < 0.05）。多因素分析表明无肝外胆管结石（OR = 0.105）为术后出现并发症的保护因素，而常规手术方式（OR = 3.952）则为其危险因素（均P < 0.05）。 结论 三维可视化联合ICG荧光成像技术运用在多次胆道手术史的肝胆管结石病诊疗中，可以提高手术的微创率和减少术后并发症发生率，该技术的应用提高了多次胆道手术史肝胆管结石病手术治疗的安全和有效性，具有重要的临床价值。

Objective To explore the application value of digital intelligent diagnosis and treatment technology in the diagnosis and treatment of hepatolithiasis following multiple biliary tract operations. Methods A retrospective cohort study was carried out to enroll patients with a history of biliary duct surgery who underwent choledochoscopy combined with hard lithotomy at Zhujiang Hospital of Southern Medical University between January 2017 and December 2024. These patients were then divided into the 3DVT-FI group and the conventional surgery group. Subsequently， the clinical data of the two groups were collected， analyzed， and compared. Results A total of 63 patients were included， with 33 in the 3DVT-FI group and 30 in the conventional surgery group. After inverse probability of treatment weighting （IPTW）， there was no statistically significant difference in the general data （P > 0.05）. The laparotomy rate， intraoperative blood loss， postoperative complication rate， and reoperation rate within 3 months in the 3DVT-FI group were significantly lower than those in the conventional surgery group （all P < 0.05）. Univariate analysis showed significant differences between the groups with and without postoperative complications in terms of the presence of extrahepatic bile duct stones， year of surgery， and surgical approach （P < 0.05）. Multivariate analysis indicated that the absence of extrahepatic bile duct stones （OR = 0.105） was a protective factor against postoperative complications， whereas the conventional surgical approach （OR = 3.952） was a risk factor （all P < 0.05）. Conclusions The application of 3D visualization in combination with ICG fluorescence imaging technology in the diagnosis and treatment of hepatolithiasis following multiple biliary tract operations can enhance the rate of minimally invasive procedures and decrease the incidence of postoperative complications. The utilization of this technology can improve the safety and effectiveness of surgical treatment for hepatolithiasis in patients with a history of multiple biliary tract operations， which shows significant clinical value.