Abstract: Objective To investigate the efficacy of rigid choledochoscopy and three-dimensional visualization-guided surgery in the treatment of patients with complex intrahepatic cholelithiasis. Methods 58 patients with complex intrahepatic cholelithiasis were recruited in our hospital between March 2014 and March 2016. The CT scan was reconstructed by three-dimensional visualization,and partial hepatectomy or common bile duct incision exploration was performed based on the simulation surgery. Results The real surgery was in 100% conformity with the preoperational three-dimensional visualization reconstruction;31 patients received partial hepatectomy with the incised volume of （241.6±26.2） mm³ in accordance with the reconstruction,and 27 patients received common bile duct incision exploration;36 patients underwent bile duct dilatation and bile duct stent for bile duct patency;bile duct stones were removed under rigid choledochoscopy in one-stage surgery,except 3 cases were removed in second stage surgery because of pyogenic cholecystitis or elderly age with multiple stones; there was no stone recurrence during 9 to 31 months of follow-up. Conclusion Three-dimensional visualization-guided individualized surgery and application of rigid choledochoscopy is safe and effective in the treatment of patients with complex intrahepatic cholelithiasis. The regimen can improve the rate of stone removal and reduce the long-term recurrence.

Key words: Cholelithiasis, Three-dimensional visualization, Rigid choledochoscopy, Therapy