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.