Gallstone disease is a common disease in China. Gallstones can be distributed in any part of the biliary tract, including gallbladder, extrahepatic bile duct (including common bile duct and common hepatic duct) and intrahepatic bile duct. With the widespread use of duodenoscopy, choledochoscopy and laparoscopy, the combined treatment of bile duct stones has become increasingly mature. Compared with traditional surgery, there is a consensus that minimally invasive surgery has significant advantages, such as unobtrusive surgical incisions, smaller surgical trauma, and faster postoperative recovery, which meets the needs and interests of patients and has become a treatment method that patients are willing to accept and prefer. This is one of the reasons for the rapid development of minimally invasive surgery at home and abroad. Laparoscopic cholecystectomy (LC) is the “gold standard” for the treatment of gallbladder stones and gallbladder polyps, and is currently the most widely used and most effective procedure in surgery. For asymptomatic gallbladder stones found by physical examination, it is safer to remove the gallbladder before the development of diabetic complications than after the development of cardiovascular and renal complications, because complications such as biliary colic, acute cholecystitis and even gallbladder gangrene may occur at any time. It is safer to operate afterwards. In patients with combined coronary artery disease, removal of the gallbladder containing stones often results in significant improvement in coronary artery disease, including improvement or disappearance of objective indicators such as arrhythmias and coronary ischemic ECG changes. For elderly patients with gallbladder stones, LC is particularly suitable, especially for those with combined diabetes, coronary artery disease and hypertension, who should seek the opportunity to perform LC as early as possible based on improving cardiovascular disease and controlling blood sugar, but should be cautious. In recent years, “biliary stone extraction” has become a major concern for patients and a focus of discussion and debate among surgeons. The recurrence of stones after surgery is a major issue of debate. The new minimally invasive laparoscopic choledochoscopy has brought the advantages of choledocholithotomy into full play and significantly reduced the recurrence rate of gallbladder stones compared to traditional choledocholithotomy. Patients with gallbladder stones can be considered for cholecystectomy when they have the following conditions: (1) young patients with good gallbladder function; (2) basically normal gallbladder size and gallbladder wall thickness <3mm; (3) no stone obstruction in the gallbladder duct; (4) few gallbladder stones; (5) no recent acute attack; (6) patients have clear requirements for gallbladder preservation and fully understand the possibility of stone recurrence. The most commonly used approach is EST+LC, i.e., EST is performed before LC to remove the common bile duct stones, the advantage of which is that when EST The advantage is that when EST fails or complications arise, laparoscopic common bile duct exploration (LCBDE) or open surgery can be used, and the imaging during ERCP provides clear imaging data for later surgery, which can not only understand the size, number, and location of stones, but also sometimes help to understand the condition of the cystic duct and intrahepatic bile duct, greatly reducing the blindness of common bile duct exploration. The more advanced way is LC + intraoperative EST, which can solve gallbladder stones and common bile duct stones at the same time in one operation, but the requirements for instrumentation are high and difficult to be popularized in China. Since EST destroys the integrity of the sphincter of Oddi, the best indication for its treatment of common bile duct stones is middle-aged and elderly patients who have had their gallbladders removed and do not have significant bile duct strictures. Compared with EST, LCBDE preserves the integrity of the sphincter of Oddi and avoids the long-term complications associated with sphincter of Oddi incision.LCBDE can be performed in many ways, such as blind extraction with instruments, biliary flushing, mesh basket extraction, etc. It can also be performed under direct vision with the help of choledochoscope, which reduces the blindness of stone extraction and can remove intrahepatic I-II bile duct stones, but the operation of choledochoscopy is more demanding. 3. LTCBDE is a product of the combination of laparoscopy and choledochoscopy, in which the choledochoscope after LC completes the exploration of the common bile duct through the cervical duct of the gallbladder and retrieves the stone by mesh basket under direct vision. The advantages of this technique are that the common bile duct is not incised and the cystic duct is routinely closed after exploration, avoiding complications such as bile leak and bile duct stricture due to common bile duct suture, and the procedure is less invasive and almost similar to LC alone, but the technique is very demanding and not yet popular. The treatment of intrahepatic bile duct stones is relatively complicated, and clinical research on minimally invasive treatment has been carried out in recent years. Hepatectomy is the most effective way to treat intrahepatic bile duct stones. With the rapid development of laparoscopic surgical instruments, the application of LigaSure and ultrasonic knife has led to better control of bleeding and continuous improvement of laparoscopic liver resection techniques, among which regular resection of the left outer lobe of the liver is expected to become the gold standard for laparoscopic liver resection. Combined with intraoperative cholangioscopic intrahepatic bile duct exploration technology, the difficulty and complexity of traditional surgical procedures have been greatly reduced. In addition, choledochoscopy can simplify the first-stage surgery and reduce the surgical trauma and complications; moreover, the second-stage stone extraction is relatively convenient and complete. The treatment of biliary stones by various minimally invasive techniques is one of the concrete manifestations of the progress of surgical treatment technology in the minimally invasive era, and the application of minimally invasive surgical techniques is not a negation of traditional surgery, but a useful supplement to traditional treatment technology. Regardless of the approach, the principle of "removing the lesion, relieving the obstruction, removing the stone, and clearing the drainage" must be followed, and an "individualized" treatment plan must be formulated according to the patient's condition and needs. Last year, our hepatobiliary surgery department was the first one to introduce electronic choledochoscope in Shandong, and has been carrying out intraoperative and postoperative choledochoscopic lithotripsy, which has been welcomed by patients and achieved good social benefits.