Diagnosis and treatment of primary hepatolithiasis Lau Wan-Yee, Lai Chun-Hung, Lau Hiu-Yan. The Chinese University of Hong Kong, Hong Kong, China Corresponding author: Lau Wan-Yee, E-mail: josephlau@cuhk.edu.hk Abstract The best definitive management of primary hepatolithiasis is to use a multidisciplinary approach. The basic principle of management of primary hepatolithiasis is to control infection during an acute attack of cholangitis, and then to eradicate all stones, strictures, and destroyed liver segments by elective definitive surgery when the disease is quiescent. The type of definitive procedures for patients who settled on conservative measures depends on the frequency and severity of each attack, presence of biliary strictures, and any existing co-morbid medical conditions of the patients.