Progressive jaundice is the main symptom of cholangiocarcinoma (80%-90%). Other symptoms such as weight loss, thinness, enlarged liver and sometimes palpable enlarged gallbladder are all common symptoms of this disease. Clinical manifestations are mainly progressive jaundice with epigastric discomfort, loss of appetite, emaciation, and pruritus. If combined with gallstones and biliary tract infection, there may be chills, fever, etc., and paroxysmal abdominal pain and vague pain. If the cancer is located on one side of the hepatic duct, it is often asymptomatic at first, and obstructive jaundice appears only when it affects the opening of the opposite hepatic duct. If the cancer in the middle bile duct is not accompanied by gallstones and infection, it is mostly painless progressive obstructive jaundice. Jaundice generally progresses rapidly and does not fluctuate. On examination, the liver is enlarged and hard, and the gallbladder is not enlarged. If the lower part of the common bile duct is present, an enlarged gallbladder may be palpable. If the tumor ruptures and bleeds, there may be black stool or positive fecal occult blood test, anemia and other manifestations. In general, although jaundice is an obvious symptom of the disease, its correct diagnosis is often difficult, and it is easily confused with common bile duct stones, especially before the appearance of jaundice. In recent years, with the development and improvement of diagnostic imaging techniques, the rate of correct preoperative diagnosis has increased considerably, and it is important to select the appropriate tests in a timely manner for patients with suspicion so that early diagnosis and treatment of the disease can be made.