1. Laparoscopic transcystic ductal exploration for stone extraction The literature reports that transcystic ductal exploration should be the first choice for the management of bile duct stones in laparoscopic surgery. Laparoscopic transcystic ductal exploration for stone extraction utilizes the natural opening of the cystic duct for stone extraction purposes and completes the procedure with a simple ligation of the cystic duct, making the operation simple and minimizing the possibility of bile leakage. Fiberoptic choledochoscopy is necessary for transcystic ductal stone extraction (the diameter of the one used in our group is 5 mm). Since most of the cystic ducts converge into the common bile duct at an acute angle, the operation of choledochoscopy is restricted by the bureau, therefore, this method is not suitable for patients with stones above the common hepatic duct. We believe that laparoscopic transcystic ductal exploration for stone extraction is the best choice for the management of patients with stones in the lower common bile duct and with stones <6 mm in diameter and <5 in number. No T-tube is left in place after surgery, which reduces patient pain, but also places higher demands on intraoperative stone removal. 2. LCBDE, T-tube drainage LCBDE has now become a mature technique in many hospitals in China. Hu Sanyuan et al. reported that the net stone rate was 250/260 and the complication rate was 17/260; our hospital has reported 23 cases of LCBDE, 19 cases of T-tube retention, 9 cases of residual stones, the net stone rate was 10/19; 1 case of bile leakage. In our group, 2 cases of bile leakage occurred in 43 cases, and the net stone rate was 36/43, which is an improvement compared with the previous group, indicating that with the accumulation of the number of cases and the improvement of the surgeon's experience and technical level, the success rate of LCBDE surgery is also increasing. LCBDE and T-tube drainage surgery are less traumatic, and the patient recovers quickly and the hospital stay is shortened, which is an effective way to treat common bile duct stones. 3, LCBDE, one-stage suturing Scholars at home and abroad have conducted a lot of research on one-stage suturing after LCBDE, and believe that this method is safe, feasible, successful and excellent, but must strictly grasp the indications and contraindications for surgery. (1) the internal diameter of the common bile duct should be more than 08-10 cm, and the narrowing or obstruction of the lower end of the common bile duct should be excluded; (2) a 100% lithotripsy rate of multiple stones in the intra- and extrahepatic bile ducts or mud-like stones that are difficult to remove should be excluded; (3) accurate and strict suturing skills, with fine sutures, preferably using non-invasive absorbable sutures; (4) the use of bioprotein glue; (5) the use of bile duct sutures; and (6) the use of bile duct sutures. (5) The availability of cholangioscopy, intraoperative cholangiography, intraoperative ultrasound and other related equipment. In addition, excessive intraoperative probing should be avoided to stimulate the common bile duct, so as not to cause congestion and edema of the bile duct wall and the lower end of the common bile duct, increasing the risk of bile leakage; postoperative drains should be routinely placed. Bile leak occurred in 4 out of 17 patients in our group, and the difference was significant when compared with the transcystic duct exploration and stone extraction group and the LCBDE and T-tube drainage group. In addition, one-stage suturing also emphasized a 100% lithotripsy rate. The success of transcystic duct exploration for stone extraction can be reviewed again by transcystic ductography. 4. LC combined with preoperative or postoperative ES For some elderly patients who are in poor general condition and cannot tolerate general anesthesia and surgical procedures, ES has successfully reduced the mortality rate in this population. In addition, a small number of patients with bile duct stones found after LC have avoided secondary surgery with the help of ES, which does not require a T-tube and has a short and painless operation time. (1) the incidence of recent complications including pancreatitis, cholangitis and bile duct residual stones has not changed much in the past 10 years, especially the incidence of pancreatitis is on the rise, and some reports show that the incidence of pancreatitis is higher in younger patients and relatively healthy patients; (2) stone regeneration due to loss of Oddi sphincter function and stenosis at the opening of the biliopancreatic jugular due to scar growth and contracture after incision; (3) the increased risk of bile duct cancer. In addition, the relatively expensive cost of the procedure is also an issue to be considered. Therefore, we believe that ES cannot be the mainstream treatment for bile duct stones, and ES can be the treatment of choice for specific populations with advanced age and/or greater risk of anesthetic surgery, and a procedure that preserves the function of the sphincter of Oddi should be preferred for young and middle-aged patients. With the advancement of technology, different approaches can be considered for the management of bile duct stones in laparoscopic surgery. As for their advantages and disadvantages, we believe that there are no fixed principles to follow and the operator needs to make the most suitable procedure for the patient according to the patient's specific situation, his or her own level of experience and the relevant equipment conditions. In general, in our experience, transcystic ductal exploration for stone extraction should be considered first; followed by LCBDE and T-tube drainage; LCBDE and one-stage suture are suitable for some patients with conditions, and their indications must be strictly grasped; while ES is a good complement to surgical procedures.