Objective: To investigate the clinical efficacy of lithotomy through incision of the second portal region parenchyma for complicated bile duct stones around the second porta hepatis. Methods: The clinical data of 28 patients with complicated bile duct stones around the second porta hepatis admitted during January 2008 to January 2014 were retrospectively analyzed. Results: In these patients, the stones were largely located in segment II, IV and VIII; lithotomy through incision of the second portal region parenchyma was the main surgical procedure performed, in addition with choledocholithotomy or partial hepatectomy. Death during hospitalization occurred in one case, and the incidence of postoperative complications was 14.8%. Twenty-five patients were followed up for one year to 4 years, postoperative stone clearance rate was 81.5% and final clearance rate was 92.6% after postoperative choledochoscopic lithotripsy, and the stone recurrence rate was 11.1%. Conclusion: Lithotomy through incision of the second portal region parenchyma offers certain efficacy for patients with complicated bile duct stones around the second porta hepatis, especially those unable to tolerate multisegmentectomy.