Hepatobiliary stones are an Asian disease that is prevalent in the central and western regions of China. The surgical management of hepatobiliary stones is a complex surgical system project, which is difficult because bile duct stones are often combined with biliary stenosis, and if there is bile duct deformity, it will increase the difficulty of surgical management. According to the principles of “stone removal, resection of diseased liver, stenosis relief, deformity correction, and drainage”, we have successfully completed a large number of cases and accumulated rich clinical experience in the traditional surgical management of such diseases, but we have limited experience in minimally invasive management, and further exploration and improvement are necessary. We have done a lot of work in minimally invasive surgery to remove the diseased liver and have proved the superiority of minimally invasive treatment of hepatobiliary stones. However, certain hepatobiliary stones, which do not require liver resection but only stone removal, bile duct stricture release and bile duct malformation correction, still need our minimally invasive surgery to try and develop. Recently, we successfully completed a case of complex laparoscopic minimally invasive surgery for hepatobiliary duct variation, hepatic duct stenosis and hepatobiliary stones, unveiling the work in this field. Patient Liu, female, 45 years old, had epigastric pain with chills and fever for more than twenty years without jaundice. Long-term conservative treatment could not be cured, and recurrent attacks affected her life and requested surgery! In the preoperative discussion, open surgery was mostly advocated, but minimally invasive surgery was attempted with the support of the chief expert, Prof. Wu Jin-Ju, and the president of the hepatobiliary hospital, Prof. Jiang Bo. As to whether to cut the left liver and biliary intestinal drainage, it was quite controversial! However, due to the principle of liver preservation and maintenance of normal physiology, we finally chose: splitting the left hepatic duct to remove the intrahepatic bile duct stones, bile ductoscopy to assist in stone extraction, and bile duct reconstruction with a T-tube drainage! The operation was performed as planned and the preoperative judgment was confirmed to be accurate. The left hepatic duct was split throughout the operation to remove the massive cast stones and secondary bile duct stones in the left hepatic Il, Lll, IV, V, Vlll and Ix segments. How to release the stenosis surgically? There were two options: 1 not to open the right posterior hepatic lobe bile duct and keep its original outflow channel; split the left hepatic bile duct with the jejunum for bile-intestinal Roux-en-y drainage; 2 cut the right posterior hepatic lobe bile duct above the duodenal margin and split the left hepatic duct to form and drain the T-tube. I finally chose the second option for the following reasons: the right posterior lobe bile duct is 8 cm in diameter and can be split and spliced with the adjacent left hepatic duct, preserving the normal stay-out tract! The right posterior hepatic lobe bile duct was further incised throughout the procedure, and the medial wall was spliced with the medial wall of the left hepatic duct to form a wide bile duct, a T-tube was placed, and then the two lateral walls were sutured together. The patient recovered well after the surgery and was discharged as scheduled. This case is a successful attempt of minimally invasive laparoscopic treatment of hepatobiliary duct variation, hepatic duct stenosis and hepatobiliary stones, which not only removes stones, but also corrects bile duct deformity and relieves stenosis, and finally achieves the purpose of liver preservation.