Objective：To explore the diagnosis and treatment of hepatolithiasis complicated by both liver abscess and cholangiocarcinoma.
Methods：Fourteen patients with hepatolithiass complicated by both liver abscess and cholangiocarcinoma admitted from July 2004 to September 2009 were retrospectively analyzed.
Results：The cases complicated by both liver abscess and cholangiocarcinoma accounted for 0.58% (14/2432) of the hepatolithiasis patients admitted during the same period.  Five cases were diagnosed before operation (5/14, 35.7%), 7 cases were detected by intraoperative  pathological examination and 2 cases were identified by the postoperative final pathological diagnosis. The tumor resection rate was 50.0% (7/14). At follow-up period, all the 5 patients who underwent tumor resection survived more than 1 year and 1 patient survived for 5 years and 3 months after operation; but 4 patients who underwent non-resective palliative surgery survived for 1 month, 6, 7 and 13 months, respectively.
Conclusions：Cholangiocarcinoma should be considered in patients who have a history of hepatolithiasis for many years and complicated by liver abscess. Early diagnosis and aggressive surgical resection are crucial for improving the outcomes in these patients.