Hepatolithiasis associated with cholangiocarcinoma: a report of 32 cases JIANG Li，CHEN Xiao-ping. Institute of Hepatopancreatobiliary Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China Corresponding author：CHEN Xiao-ping, E-mail：chenxp@medmail.com Abstract Objective To study the clinical features, diagnosis and treatment of hepatolithiasis associated with cholangiocaminoma. Methods The clinical data of 32 patients with hepatolithiasis associated with cholangiocarcinoma admitted from 1993 to 2007 at Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology were analyzed retrospectively. Results Cholangiocarcinoma occurred in 1.9% of patients with hepatolithiasis, with diagnosis established preoperatively in 19 (59.4%) patients. The incidence of peripheral cholangiocaminoma and hilar cholangiocaminoma was 43.8% and 50% respectively. Only 10 (31.3%) patients underwent radical resection, and other 15(46.9%) patients received palliative management. In the 28 patients followed-up closely, average survival time was 22 months in radical surgery group, whereas the average survival time was about 9 months in palliative operation group. Conclusion Long-term chronic inflammation due to hepatolith within the bile duct system contributes to the development of cholangiocarcinoma. The radiologic and clinical findings of patients with long-term hepatolithiasis and a history of biliary operation should be attentively investigated for the possible presence of a cholangiocarcinoma, of which the prognosis is still poor because of the difficulty to achieve early diagnosis and radical resection.