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 usually 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 can be found. If the tumor ruptures and bleeds, there may be black stool or positive fecal occult blood test, anemia and other manifestations. Any jaundiced patient over 40 years of age, or with unexplained upper abdominal discomfort, distension, nausea and other gastrointestinal symptoms, and enlarged liver with or without gallbladder enlargement, should suspect cholangiocarcinoma and undergo further ultrasound, CT, MRI, ERCP, ultrasound endoscopy, cholangioscopy, PTC, hypotonic duodenography, or selective angiography to confirm the diagnosis. In general, although jaundice is an obvious symptom of the disease, its correct diagnosis is often difficult and can be easily confused with common bile duct stones, especially before the appearance of jaundice, which is not easy to make a clear diagnosis. 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 that patients with suspicion should be promptly selected for appropriate investigations, so that the disease can be diagnosed and treated at an early stage.