Background and Aims: The diagnosis and treatment of intrahepatic bile duct stones, especially the stones located in multiple hepatic segments or the complicated hepatolithiasis with a history of multiple biliary tract surgeries, is one of the difficult problems in hepato biliary surgery. How to remove the stones in one step is one of the current research interests. Considering that the computer-based three-dimensional reconstruction visualization technology has been increasingly used in hepatectomy in recent years, this study was designed to investigate the clinical application value of computer-based three-dimensional reconstruction technology in the diagnosis and treatment of complicated intra- and extrahepatic bile duct stones. 
Methods: The clinical data of patients with hepatolithiasis treated in the Department of Biliary and Pancreatic Surgery of the First Affiliated Hospital of University of Science and Technology of China, who underwent computer-based three-dimensional reconstruction before operation from January 1, 2018to July 31, 2019 were retrospectively analyzed. 
Results: A total of 19 patients with complicated hepatolithiasis admitted during above period were enrolled. Of the patients, the classification of hepatolithiasis was type I in 9 cases, type II a in 6 cases, type IIb in 3 cases and type IIc in 1 case, 12 cases had concomitant extrahepatic bile duct stones, 1 case was complicated with hepatic space-occupying lesions and 1 case was combined with right hepatic schistosomiasis. The surgical procedures including left hepatectomy performed in 3 cases, right hepatectomy performed in 7 cases, and common bile duct exploration plus drainage performed in 9 cases. The coincidence of preoperative three-dimensional reconstruction with the real intra-operative findings were that the coincidence rate of the running patterns of the portal vein and hepatic artery were 78.95%, the coincidence rates of both stone distribution in bile duct and liver volume were 84.21%, and the total accuracy rate was 73.68%. No residual stones were detected by immediate postoperative cholangiography, and no postoperative cholangitisor bile duct injuries occurred.
Conclusion: The preoperative computer-based three-dimensional reconstruction technology can accurately describe the distribution of intrahepatic bile duct stones and accurately measure the liver volume. It has important clinical application value in the diagnosis of complex hepatolithiasis and individual planning of surgical procedures, and can help achieve the greatest degree of stone removal in one step.