复杂性肝胆管结石的治疗仍是肝胆外科医生面临的一个棘手课题。本文在认识和研究的基础上对复杂性肝胆管结石的概念、诊断、围手术期的处理要点，双侧肝胆管结石、再次手术的肝胆管结石及肝胆管结石合并门静脉高压、脾功能亢进的治疗进行分析。强调对复杂性肝胆管结石的治疗必须作充分的术前准备、详尽的影像学检查，对胆管树影像要有详细的了解，应由肝胆外科专科医生进行手术，这样才能取得良好的效果。

Diagnosis and management of complicated hepatolithiasis LIANG Li-jian, LI Shao-qiang. Department of Hepatobiliary Surgery, the First Affiliated Hospital, Sun Yet-san University, Guangzhou 510080, China. Corresponding author: LIANG Li-jian,E-mail： lianglj@medmail.com.cn Abstract The management of complicated hepatolithiasis still remains a challenge for hepatobiliary surgeons. In this article we focus on the evaluations of the definition, diagnosis and perioperative management of complicated hepatolithiasis. And we also evaluate the management strategies of bilateral intrahepatic stone, reoperation for hepatolithiasis and hepatolithiasis combined with portal hypertension and hyperspleenism based on our experience. We conclude that proper preoperative management, detailed imaging evaluations especially biliary tree study are critical important for successful treatment. The operation should be performed by specialist of hepatobiliary surgeons.