The symptoms of cholangitis present as abdominal pain, fever, chills and jaundice, known as the Charcot triad. However, there are many patients who lack the full triad of symptoms. Most patients have sudden right-sided subxiphoid colic that may radiate to the back of the right shoulder, while a few may be completely painless, with only epigastric distress. About two-thirds of patients develop chills and high fever following an acute abdominal pain episode. Jaundice usually begins 12 to 24 hours after the onset of abdominal pain, by which time the abdominal pain is often relieved. How do bile ducts become acutely inflamed? How can the bile ducts become inflamed? Wang Wei explains that 90% of biliary duct infections are caused by stones, just like cholecystitis. Primary bile duct stones can be caused by poor dietary hygiene, ascariasis, biliary tract infection, cirrhosis, etc. Secondary bile duct stones are formed when stones in the gallbladder enter the common bile duct through the enlarged cystic duct. The main cause of cholangitis attacks is the blockage of the bile duct by gallstones, which obstructs the bile discharge and causes bile retention and inflammation. Although there are bacteria in the bile ducts of normal people, they are diluted by bile flushing and do not cause inflammation because of the smooth flow of bile. Once the bile ducts are blocked, the bile is like stagnant water in a pool, and bacteria take advantage of the opportunity to move around and eventually become infected and septic. The more the common bile duct becomes blocked, the higher the pressure in the bile duct becomes, causing dilation, congestion, and edema. The toxic bacteria will spread to the liver and through the blood sinusoids of the liver, a large amount of toxins will run into the blood, and the person will be poisoned, shock, and in severe cases, death. Therefore, once bile duct inflammation occurs, surgery is needed immediately to drain the pus and toxic bile out of the body. Some patients who have had their gallbladder removed think they can rest easy, but then they realize that biliary ductitis has occurred. There is no necessary connection between the removal of the gallbladder and the occurrence of stones in the bile ducts, which in turn causes bile duct obstruction. If gallbladder stones are found within two years after gallbladder removal, it is possible that stones had fallen into the bile duct before the gallbladder was removed but were not detected on imaging because they were too small or because of the angle. When bile duct stones appear after two years, they are generally considered to be primary bile duct stones. The presence of stones is the root cause of sudden inflammation of the bile ducts, and the presence of stones is a hidden problem that can block the “sewer” at any time. Of course, if there are three to four doctors with the required technical skills, ERCP can be considered for examination and treatment through the duodenoscope and retrograde intubation of the bile ducts through the gastrointestinal tract to help remove stones, but this treatment also has the same risks, and it is more difficult to do ERCP in patients with acute infections. Therefore, in order to avoid emergencies, adults, especially the elderly, should have frequent checkups to detect stones in the bile ducts by ultrasound and to remove them by ERCP before inflammation occurs to avoid serious consequences. Early removal of bile duct stones is significant as it not only causes bile duct inflammation, but also affects the pancreas and causes acute pancreatitis. When stones in the bile duct move downward, they are blocked at the “valve”, resulting in poor bile-pancreatic drainage; alcohol and high-fat diet stimulate edema of the duodenal papilla (i.e., the drainage valve of the biliopancreatic duct), resulting in bile reflux to the pancreatic duct and causing high pressure in the pancreatic duct, all of which can cause abnormal activation of pancreatic enzymes, leading to acute pancreatitis. These factors can cause abnormal activation of pancreatic enzymes, which can lead to an attack of acute pancreatitis, resulting in pancreatic and peripancreatic necrosis and infection. The risk of severe acute pancreatitis is very high, with a mortality rate of 30%. The removal of bile duct stones can prevent both cholangitis and acute pancreatitis. Reminder: dietary care of bile duct stones 1, eat less fatty food, such as fatty meat, fried food, try to use vegetable oil instead of animal oil; 2, limit the amount of cholesterol-containing food, such as fish roe, eggs, egg yolk, carnivore liver, kidney, heart, brain, etc.; 3, the diet to steam stew stew and other light is better, do not fry, fried, burnt, baked, smoked, pickled food; 4, increase the intake of fish, lean meat, soy products 4, increase the intake of fish, lean meat, soy products, fresh vegetables, fruits and other foods rich in high-quality protein and carbohydrates; 5, it is appropriate to eat more tomatoes, corn, carrots and other foods rich in vitamin A; 6, increase the number and quantity of water, meals, increase the secretion and excretion of bile, reduce the inflammatory response and bile stasis; 7, avoid tobacco and alcohol, and spicy stimulating cold food. Such as chili, mustard.