To summarize the technical characteristics of regular laparoscopic hepatectomy for hepatolithiasis.

Clinical data of 33 patients with hepatolithiasis who underwent regular laparoscopic hepatectomy in Yijishan Hospital of Wanna Medical College from February 2014 to September 2019 were retrospectively analyzed. The informed consents of all patients were obtained and the local ethical committee approval was received. Among them, 19 patients were male and 14 female, aged from 33 to 76 years with a median age of 60 years. Hepatic stones of 17 cases were observed in segment Ⅱ and Ⅲ, and 16 cases in segment Ⅱ, Ⅲ and Ⅳ. 25 cases were classified as Child-Pugh grade A and 8 cases as grade B. Five-port laparoscopic left lateral lobectomy or left hepatectomy was performed, the porta hepatis was carefully dissected, the perihepatic ligament was properly separated, the transected liver plane was made avoiding the stones and the liver was explicitly resected to ensure no residual stones in the bile duct of remnant liver. The surgical condition and efficacy were observed. The technical characteristics were summarized.

All patients completed the laparoscopic surgery, and no patient was converted to open surgery. 17 cases underwent left lateral lobectomy combined with common bile duct exploration, 15 cases of left hepatectomy combined with common bile duct exploration, and 1 case of simple left hepatectomy. The median operation time was 319(120-480) min, the intraoperative blood loss was 145(50-600) ml. 4 cases received blood transfusion with an amount of 450(400-600) ml. Postoperative bleeding occurred in 3 cases, acute cholangitis in 1 case, abdominal infection in 1 case and bile leakage in 4 cases. The length of postoperative hospital stay was 9(6-17) d.

Laparoscopic regular hepatectomy for hepatolithiasis has unique technical requirements, which should be performed with the principle of minimally invasive and precise hepatectomy.