关键词: 腹腔镜肝切除, 肝胆管结石, 循肝中静脉, 经肝管取石

Abstract: Hepatolithiasis is a common biliary disease in China, characterized by complex pathology. The intertwined and dilated bile ducts spread throughout the liver, making it difficult to resect completely, resulting in a high rate of postoperative stone residuals and recurrence. Through long-term practice, our team has found that the middle hepatic vein serves as a natural boundary for the left or right diseased bile ducts,and the diseased bile ducts can be thoroughly excised with the middle hepatic vein as the anatomical mark. Therefore, this paper systematically summarizes the clinical application of laparoscopic middle hepatic vein-guided anatomical hemihepatectomy combined with transhepatic duct lithotomy, which can effectively relieve stenosis, reduce the residual rate and recurrence rate of stones, and achieve the objectives of “eliminating the lesion, removing all stones, correcting strictures, ensuring smooth drainage, and preventing recurrence.” 

Key words: laparoscopic hepatectomy, hepatolithiasis, middle hepatic vein, transhepatic duct lithotomy