Intrahepatic choledocholithiasis symptoms are not obvious or atypical, mostly discomfort in the right upper abdomen, or mild pain, stuffiness and swelling. In severe cases, it may manifest as the symptoms of cholangitis, i.e. chills, fever, jaundice and even shock, and liver abscess. Some manifest as cirrhosis of the liver. Xue Jianfeng, Department of Hepatobiliary, Pancreatic and Liver Transplantation Surgery, First Affiliated Hospital of Zhengzhou University There are also many patients (about 20%) who are asymptomatic and are found during physical examination. Diagnosis relies on color ultrasound. The treatment of intrahepatic bile duct stones requires individualized treatment and comprehensive judgment based on the different symptoms of each patient, the different locations of the stones, the presence or absence of combined hepatic atrophy, and the presence or absence of stenosis of the bile ducts in the hepatoportal region.1 No treatment is required and regular observation is sufficient for stones located in the peripheral bile ducts, for those who are asymptomatic clinically, and for those who do not have bile duct dilatation at the distal end of the stone.2 Simple choledochotomy for stone extraction and T-tube drainage: interpretation of intrahepatic bile duct stones It is better to go to the unit with cholangioscopy, intraoperative cholangioscopy can greatly reduce the postoperative interpretation of the residual rate, but also can understand the presence of intrahepatic bile duct stenosis, to take the appropriate surgical approach, after surgery can no longer open the abdomen but through the T-tube channel to remove the stone.3 Combined hepatic lobectomy, Japanese scholars believe that symptomatic patients with intrahepatic choledocholithiasis are combined with 90% of the hepatic atrophy, and asymptomatic hepatic atrophy is only about 15%, especially the left side of the liver, the incidence of liver atrophy is only about 15%. about 15%, especially in the left outer lobe of the liver, and the lower part of the right posterior lobe. In many units, only choledochotomy is performed to remove the stone, without judging the partial resection of the liver, which leads to reoperation and brings more trauma and medical cost to the patient, and even causes cancer.4 Enlargement of the bile duct in the hepatoportal part of the bile duct molding of the choledocho-jejunal anastomosis, for intrahepatic choledocholithiasis, it is necessary to judge the existence of bile duct stenosis, and if the stenosis is not lifted, the recurrence of the stone will be unavoidable, and the stone can not be removed, and the symptom will not be relieved.5 For patients whose liver is full of stone In patients with hepatic insufficiency, liver transplantation is often needed for those with dilated intrahepatic bile ducts and gallstones.