目的： 探讨以“十字坐标线定位法”为基础实现关键性安全视野(CVS)在腹腔镜胆囊切除术(LC)中的应用体会。方法： 选择2020年2月—2023年2月在上海交通大学医学院附属瑞金医院无锡分院接受“十字坐标线定位法”治疗的84例病人作为观察组，并随机抽取同期接受传统LC治疗的84例病人作为对照组。观察组采用“十字坐标线定位法”为界限标识，达成CVS、完成胆囊切除；对照组采用传统钝、锐结合操作方法游离胆囊三角并解剖出胆囊管和胆囊动脉逐一结扎离断。对比分析两组术中、术后及相关并发症发生情况。结果： 168例病人均顺利完成LC，无严重手术并发症和中转开腹病例。观察组手术用时长于对照组[(89.5±12.3) min 比(67.7±8.9) min，P<0.001），术中出血量少于对照组[(7.0±3.9) mL比(15.2±4.6) mL， P<0.001）。观察组胆道、血管变异发现率高于对照组（9.5%比1.2%，P=0.040）。观察组术后第一天活动能力高于对照组，术后首次进食时间、术后首次排气时间均早于对照组（P<0.05）。观察组术后并发症总发生率低于对照组（2.4%比10.7%, P=0.029）。两组引流管放置例数、住院天数差异无统计学意义（P>0.05）。结论： “十字坐标线定位法”以其恒定的解剖位置作为基础标志，可帮助手术医师快速锁定安全操作区域、实现胆囊三角CVS以避免胆管损伤、降低相关并发症的发生率。

Objective To explore the application of the “cross-shaped coordinate line localization method” in laparoscopic cholecystectomy (LC) to realize critical view of safety (CVS) as well as summarize its safety and practicality. Methods Eighty-four patients who were treated with the “cross-shaped coordinate line localization method” at the Department of General Surgery of Wuxi Branch of Ruijin Hospital, Shanghai Jiao Tong University School of Medicine from February 2020 to February 2023 were selected as the observation group, and 84 patients who were randomly selected to receive the traditional LC treatment during the same period were selected as the control group. In the observation group, the “cross-shaped coordinate line localization method” was used as the boundary mark to reach CVS, and complete cholecystectomy. In the control group, the traditional blunt and sharp operation methods were used to free gallbladder triangle, and dissect out the cystic ducts and cystic arteries one by one and ligate them off. The intraoperative, postoperative and related complications of the two groups were compared and analyzed. Results All 168 patients successfully completed LC without serious surgical complications or conversion to open cases. The observation group took longer operation time to than the control group [(89.5±12.3) min vs. (67.7±8.9) min, P<0.001), and intraoperative blood loss was less than the control group [(7.0±3.9) mL vs. (15.2±4.6) mL, P<0.001). The rate of biliary and vascular anomalies in the observation group was higher than that in the control group (9.5% vs. 1.2%, P=0.040). The observation group had higher mobility on the first postoperative day than the control group, and time to first postoperative feeding and time to first postoperative flatus were earlier than those of the control group (P<0.05). The overall incidence rate of related complications in the observation group was lower than that in the control group (2.4% vs. 10.7%, P=0.029). There was no statistically significant difference between the two groups in terms of drain placement and length of hospital stay (P>0.05). Conclusions The “cross-shaped coordinate line localization method”, with its constant anatomical position as the basic symbol, can help surgeons quickly lock the safe operation area and realize CVS of the gallbladder triangle to avoid bile duct injury and reduce the incidence of related complications.