Treatment of complicated primary hepatic lithiasis by combined right and left lobectomy：an analysis of 47 cases WANG Huai-Zhi, HE Zhen-Ping, BIE Ping, et al. Institute of Hepatobiliary Surgery of PLA, Southwest Hospital, the Third Military Medical University, Chongqing400038，China Corresponding author: WANG Huai-Zhi, E-mail：whuaizhi@gmail.com Abstract Objective To summarize the experience and evaluate the therapeutic effect of combined right and left lobectomy for complicated primary hepatic lithiasis. Methods To analyze retrospectively the clinical data of 47 patients suffering from complicated primary hepatic lithiasis underwent combined right and left lobectomy from Aug.1991 to Aug. 2007. Stones distribution, operation style, postoperative complications and therapeutic effects were evaluated. Results 15 patients out of 47 patients had underwent operations on bile duct. All of the patients have stones in both right lobe and left lobe. Out of 47 patients, 7 patients have stones in caudate lobe, 21 patients have stones in extrahepatic bile duct. 23 cased of biliary stricture were found during operations. All of the patients underwent combined right and left lobectomy. Out of 47 patients, 3 patients underwent the resection of biliary tree of right lobe, 6 patients underwent the resection of biliary tree of right posterior lobe. Additional procedures include exploration of common bile duct in 28 patients, chole-enterostomy(Roux-en-Y) in 19 patients and intrahepatic lithotomy through hepatic parenchyma. Two patients died perioperatively. Three patients had intraperitoneal infection after operation. One patient had residual stone in right anterior lobe. One patient had residual stone in left interior lobe. The follow-up time is from 16 months to 17 years.88.89% of patients has excellent life quality. Conclusion Combined right and left lobectomy has less complications, less residual stones, excellent long-term results, thus is one of the effective procedures treating complicated primary hepatic lithiasis.