ObjectiveTo explore the safety and feasibility of mixed approach laparoscopic anatomical left hepatectomy for left hepatolithiasis.MethodThe clinical data and follow-up results of 23 patients with left hepatolithiasis admitted to the Department of Hepatobiliary Pancreatic Surgery in Leshan People’s Hospital from June 2018 to June 2020 were retrospectively analyzed.ResultsAll 23 patients underwent anatomical left hepatectomy under laparoscopy. The median of total operation time was 185 min (153–460 min), the median of operation time of liver dissection was 110 min (90–125 min), the median of total blood loss during operation was 175 mL (100–800 mL), the median of blood loss from liver dissection was 120 mL (60–560 mL), blood transfusion was performed in 2 patients during operation. Postoperative day 1: median of AST was 75 U/L (32–437 U/L), median of ALT was 83 U/L (25–537 U/L),median of TBIL was 24 μmol/L (15.6–42.7 μmol/L); postoperative day 3: median of AST was 31 U/L (23–129 U/L),median of ALT was 27 U/L (14–108 U/L), median of TBIL was 13.5 μmol/L (10.4–24.3 μmol/L). Postoperative blood transfusion was performed in 1 patient, and the median of postoperative hospital stay was 7 days (5–20 days), median of postoperative extubation time was 2.5 days (2–5 days). Postoperative complications occurred in 3 patients. All 23 patients were followed up after the operation for median of 12 months (6–18 months). During the follow-up period, the patients had no special discomfort, no stone recurrence, reoperation, and death.ConclusionMixed approach laparoscopic anatomical left hepatectomy is safe and feasible in the treatment of left hepatolithiasis.