The nasobiliary tube is mainly used for endoscopic biliary drainage, and the more classic one is the transendoscopic nasobiliary drainage (ENBD). It uses a thin nasobiliary tube, which is inserted into the bile duct through the duodenal papilla under endoscopy, and the other end is extended out of the body through the duodenum, stomach, esophagus and pharynx, to establish an extracorporeal bile drainage route through the nostril. Through drainage, it can achieve the purpose of decompression, yellowing and anti-inflammation, and it is easy and safe to operate. Applicable population: It can be widely used in the management of bile duct obstruction caused by stone extraction, lithotripsy or hepatobiliary stones. Two types of treatment: surgical treatment and conservative medical treatment. 1, surgical treatment: divided into traditional open treatment and new minimally invasive treatment (such as laparoscopic cholecystectomy). Traditional open treatment is highly damaging to patients and has more postoperative complications, mainly for patients whose laparoscopy is contraindicated and critical. Minimally invasive treatment includes laparoscopic cholecystectomy, endoscopic lithotomy and many other options. Take laparoscopic cholecystectomy as an example, its advantages include: small incision, light injury, small scar, fast postoperative recovery, generally you can get out of bed on the day of surgery, you can eat the next day, you can be discharged from hospital in 1-3 days, you can resume daily activities in 7 days, etc. It is the preferred treatment option for patients eligible for surgery. 2.Conservative medical treatment: including herbal lithotripsy, lithotripsy with Chinese and Western medicine, lithotripsy with shock wave lithotripsy. The purpose of these methods is to preserve the gallbladder, which is quite popular among patients. However, there are disadvantages, such as poor treatment effect, easy to regrow stones, and high recurrence rate after surgery. Three mirrors: laparoscopy, choledochoscopy, and duodenal endoscopy. 1. Laparoscopy: Laparoscopic cholecystectomy is performed by inserting a special catheter into the abdominal cavity and transmitting the intra-abdominal images to the TV screen through a 1 cm thick laparoscope. The surgeon watches the TV and observes the inside of the abdominal cavity while operating. Laparoscopic resection is performed by simply making 3-4 small holes (usually in the range of 0.5-1 cm) in the abdominal wall and inserting special instruments to cut the gallbladder intact and then remove the stones from the small holes in the abdominal wall. Compared with traditional open surgery, laparoscopic surgery has small incision, light injury, fast postoperative recovery, and correspondingly less pain for patients. 2.Choledochoscopy: Choledochoscopic lithotripsy is performed by placing a fiberoptic choledochoscope along the fistula of the biliary skin and removing the stones with a lithotripsy basket (or lithotripsy net) after finding stones. Applicable population: It is generally indicated for those who have stones forming again in the bile duct after gallbladder removal. This method can directly understand the presence or absence of stones and their location, size and number in the bile ducts inside and outside the liver, observe the presence of neoplastic and intrahepatic bile duct strictures, facilitate the selection of the correct surgical approach, reduce the rate of residual stones after surgery, and simplify surgery and reduce trauma. 3, duodenal endoscopic ERCP (endoscopic retrograde cholangiopancreatography): normal human bile duct opening in the medial wall of the descending duodenum, with electronic duodenoscope through the mouth through the esophagus and stomach, into the descending duodenum, you can observe the lateral wall duodenal papilla. The diagnosis is then made by imaging of the biliopancreatic duct, and when a stone is found, the duodenal papilla is cut open with a high-frequency electric knife and the stone is removed with a stone extraction basket. This procedure has no body surface trauma, and the patient’s pain is greatly reduced and the recovery time is greatly shortened. Suitable for: common bile duct stones, obstructive jaundice of various causes, including acute obstructive purulent cholangitis, inflammation of the duodenal papilla and benign and malignant tumors of the jugular abdomen. Disadvantages: It may lead to acute pancreatitis of medical origin, duodenal papilla edema and injury. Also, ERCP cannot resolve high stones and stones inside the gallbladder. Four strategies: Treatment strategies vary from patient to patient. 1, For patients in good condition, after excluding relevant contraindications, we can give minimally invasive (laparoscopic) treatment, which is recommended for high surgical efficiency and low patient pain. 2, For some patients with a history of abdominal surgery or other contraindications to laparoscopy, we recommend traditional open treatment. Although the patient’s surgery is more traumatic, timely surgery has an extremely important role in ensuring the safety of the patient’s life, and open abdomen can see the situation in the abdominal cavity more clearly and reduce adverse reactions to surgery. 3, can also be used laparoscopy combined with duodenal endoscopy (double mirror combination). 4, or laparoscopy combined with choledochoscopy, duodenoscopy (triple combination) and other options. 3 and 4 two options are currently the world’s leading gallstone surgery technology, the technology gives full play to the respective advantages of soft and hard mirrors, complementing each other’s strengths and creating favorable conditions for each other, making certain difficult problems to solve, thus better guaranteeing the safety of patients’ lives.