Estabolishment of subcutaneous permanent tunnel to bile duct and its role on the treatment of patients with hepatolithiasis TANG Li-jun, TIAN Fu-zhou, CUI Jian-feng, et al. Center of General Surgery, Chengdu General Hospital of PLA Chengdu Command, Chengdu 610083, China Corresponding author: TANG Li-jun, E-mail：whjtlj@yahoo.com.cn Abstract Objective To sum up the methods and clinical values to construct a subcutaneous permanent tunnel to bile duct during surgical treatment of hepatolithiasis. Methods A retrospective analysis was carried out on clinical data of 2,278 patients with hepatolithiasis, admitted from Dec. 1984 to Dec. 2008 by the Center of General Surgery, Chengdu General Hospital of PLA Chengdu Command. All patients received a surgical operation, and a subcutaneous permanent tunnel to bile duct was constructed in each patient during the surgery. Of those patients, the subcutaneous permanent tunnel to bile duct was constructed through cholecysto-hepatoledochostomy in 128 patients with regional hepatolithiasis. Results Of the 2278 patients, 792 patients were followed up. During the follow-up, 184 patients (making up of 23.23%) with recurrent bile duct stone received incision of subcutaneous tunnel and stone removal by choledochoscopy. Of them, 175 patients received incision of subcutaneous jejunal loop, and 9 patients received that of subcutaneous gallbladder. The 43 patients concurrently complicated with anastomotic stenosis received expansion with biliary balloon under choledochoscopy, and such stenosis were corrected to different extents. All patients were recovered and discharged out of the hospital. Conclusion During surgery of patients with hepatolithiasis, it is a key procedure for treatment of post-surgical recurrent stone to construct a subcutaneous permanent tunnel to bile duct. For patients with regional hepatolithiasis, it may still be a simple and reliable method to construct a subcutaneous permanent tunnel to bile duct via gallbladder.