Gallstone disease (i.e. gallstones) is divided into gallbladder stones, intrahepatic bile duct stones, and extrahepatic bile duct stones (common bile duct stones); extrahepatic bile duct stones (common bile duct stones) is one of the three diseases that must be treated surgically for gallstone disease, which needs to be brought to the attention of patients, so as not to delay treatment or even bring about life-threatening risks with cholangitis and then surgery. What is extrahepatic bile duct stone: It refers to the bile duct stone below the confluence of the left and right hepatic ducts. The main hazards and pathological changes of extrahepatic bile duct stones are: 1. Acute and chronic cholangitis are the most common; 2. Systemic infection (requires emergency treatment); 3. Clinical manifestations: the triad of pain and fever, but the chance of occurring simultaneously is about 70%, that is, abdominal pain, jaundice (yellow eyes, yellow urine, yellow skin), and fever can appear only one of the symptoms or two in combination, and in severe cases there can be shock or psychiatric symptoms. If these symptoms occur, you should go to the hospital for examination and judgment by a hepatobiliary and pancreatic specialist. Treatment of extrahepatic bile duct stones: Once found, extrahepatic bile duct stones should be taken seriously and treated with early and active surgery. There are various surgical methods, each with its own advantages and disadvantages, and there are also some controversies in the understanding. 1 Conventional open cholecystectomy, choledochotomy and T-tube drainage: the most classic method, most county hospitals and rural health centers can complete, simple, but traumatic, T-tube retention time is long, inconvenient life. 2 laparoscopic cholecystectomy, choledochotomy and T-tube drainage: less traumatic, can combine the operation It can also be used to observe the function of the duodenal papillary sphincter through the choledochoscope and provide some reference to determine the prevention of stone recurrence or reflux cholangitis.3 Laparoscopic cholecystectomy, choledochotomy, one-stage suturing: less trauma, no T-tube, convenient life, suitable for patients with intraoperative choledochoscopy or cholangiography or intraoperative ultrasound to determine that the common bile duct has been removed. Patients with stones, with the possibility of biliary leakage or biliary stricture.4 Laparoscopic cholecystectomy with transcystic duct extraction: has the advantages of the above procedures, avoids the disadvantages of the above procedures, suitable for patients with dilated cystic ducts, requires a special choledochoscope with a thin diameter during the operation, has a longer operation time, and has the possibility of increasing the chance of residual stones in the bile duct.5 Duodenal papillary sphincterotomy for stone extraction: a transoral endoscopic stone extraction It is less invasive and quicker to recover, but there are several complications: a acute pancreatitis, b duodenal perforation or bleeding, c because the papillary sphincter is cut, the one-way flow of bile is destroyed and the chance of reflux cholangitis increases, and it is easy to have recurrent fever after surgery. It is suitable for the elderly, frail, elderly, who cannot tolerate surgery, and those with small stone diameters.6 Percutaneous biliary puncture choledochoscopy for stone extraction: the procedure is less invasive and also avoids the disadvantages of No. 5, but requires repeated multiple times, increasing the treatment period.7 The procedure is the same as above, with emergency surgery: if cholangitis occurs in extrahepatic bile duct stones, especially severe cholangitis, immediate emergency surgery is required. 8 Patients with combined choledochal opening stenosis should undergo additional choledochal jejunostomy. According to our experience, we recommend 1 laparoscopic surgery, with either an indwelling T-tube or a one-stage suture depending on the case, 2 duodenal papillary sphincterotomy for stone extraction