Abstract:Objective: To investigate the clinical efficacy of laparoscopic anatomic left hemihepatectomy plus choledochoscopic lithotomy in treatment of left intrahepatic bile duct stones with extrahepatic bile duct stones. Methods: The clinical data of 12 patients with concomitant left intra- and extrahepatic bile duct stones admitted from March 2010 to September 2013 were retrospectively analyzed. All patients were definitely diagnosed having extensive stones in the left hepatic lobe and concomitant common bile duct stones, and all patients underwent laparoscopic anatomic left hemihepatectomy combined with choledochoscopic choledocholithotomy. Results: All operations were successfully completed without any open conversion. The operative time was (182.6±36.3) min, intraoperative blood loss was (213.5±65.5) mL, time to postoperative flatus was (38.5±8.2) h, and length of postoperative hospital stay was (10.3±3.1) d. Bleeding from the cut liver surface and bile leakage occurred in one case each after operation, which were all resolved by conservative treatment. Over a follow-up of 3 months to 3 years with an average of 23 months, no residual stones or new stone formation were found. Conclusion: Laparoscopic anatomic left hemihepatectomy plus choledochoscopic lithotomy is an effective and safe procedure for patients with extensive stones in the left hepatic lobe and concomitant common bile duct stones.