The decrease of reoperation rate of hepatobiliary duct stones is closely related to the common use of fiberoptic choledochoscopy after hepatobiliary duct stone extraction, most of the residual stones can be removed by fiberoptic choledochoscopy after hepatobiliary duct stone surgery, but there are some patients with embedded hepatobiliary duct stones, and the lithotripsy basket cannot pass the stones, which makes stone extraction difficult or even impossible. Plasma shock wave lithotripsy is used to break up the embedded stones by shock wave, and then the stones can be removed more easily with a mesh basket. From September 2003 to September 2009, 4422 cases of fiberoptic choledochoscopy were performed in our hospital, among which 365 cases of plasma shock wave lithotripsy were performed, accounting for 8.25% of the total number of fiberoptic choledochoscopy cases (365/4422). 364 of the 365 patients had all stones removed after isotonic shock wave lithotripsy and lithotripsy basket extraction, and one case of acute cholangitis was caused by an embedded stone in the liver. In one case, acute cholangitis was caused by an embedded intrahepatic stone, and after plasma shock wave lithotripsy had penetrated the stone, drained the pus and controlled the cholangitis, further lithotripsy and extraction was abandoned due to too many intrahepatic stones and bile duct stenosis, and another biliary surgery was performed. 12 patients had biliary bleeding, which was stopped after non-surgical treatment. No other complications occurred. The majority of patients with intrahepatic bile duct stones will have residual stones after surgery, and the residual stones will be removed by fiberoptic choledochoscopy after surgery. Even if the stone enters the basket, but the stone is too large, or the removal is too violent, it may cause stone imbedding, bile duct or T duct sinus tract tearing and cause bleeding or bile leakage into the abdominal cavity causing biliary peritonitis. Therefore, in the case of too large stones or stones embedded in the bile duct, some measures have been taken in the past, such as liquid electrolysis, simple electroshock lithotripsy, microstrike lithotripsy, biopsy forcepsy or three-jaw forceps for biting stones, etc., but they are less widely used due to poor results or other reasons. Plasma shock wave lithotripsy uses plasma shock wave lithotripter to generate shock waves to achieve the purpose of lithotripsy, compared with other lithotripsy methods, the lithotripsy effect is more satisfactory, lithotripsy operation method is simple: plasma shock wave lithotripter generates plasma shock wave, through the guide wire conduction to reach the stone site, the guide wire is inserted through the fiber choledochoscope operation channel to the stone site, close to the center of the stone, the guide wire is connected to the plasma shock wave lithotripter The guide wire is connected to a foot control switch, and the power is adjusted so that the stone is first broken by a single click and then by a series of blows until the stone is broken and can be removed through the mesh basket. The effect of plasma shock wave lithotripsy is more certain, and bilirubin stones are generally easier to be broken, while cholesterol stones are harder and more difficult to be broken, but continuous lithotripsy can generally be broken. First, plasma shock wave lithotripsy should be performed under direct vision with the lithotriptic guidewire placed in the center of the stone in direct contact with the stone, first click lithotripsy, if the position of the lithotriptic guidewire remains the same, continuous lithotripsy can be used until the stone is broken, if the lithotriptic guidewire moves and the guidewire is close to the bile duct wall, then lithotripsy should be stopped. Secondly, when lithotripsy is performed, the cholangioscope should be at a certain distance from the lithotripsy site, if it is too close to the lithotripsy site, it may cause damage to the cholangioscope; again, while lithotripsy is being performed, the biliary tract should be flushed continuously, while lithotripsy is being performed, to keep the field of view clear, otherwise the mud and sand from lithotripsy or blood seepage will affect the observation and accidentally injure the bile duct wall. Plasma shock wave lithotripsy is relatively safe as long as the operation is correct, but there are certain complications of plasma shock wave lithotripsy, the main complication is biliary bleeding, plasma shock wave lithotripsy, due to the impact of the shock wave, although the impact on the stone, but can be transmitted through the stone, the impact on the bile duct, long-term stone embedded in the bile duct mucosa caused some damage, the lithotripsy process may In general, the bleeding of the bile duct wall is oozing blood, which can be stopped by itself in most cases, but only a very small part of the bleeding continues, in this case, we usually use 8mg% norepinephrine saline to flush the bile duct. In such cases, we usually flush the bile duct with 8 mg% norepinephrine saline and the bleeding stops gradually. In some patients with plasma shock wave lithotripsy, some patients have electric shock-like sensation, which is actually the shock wave impact feeling. Plasma shock wave lithotripsy is safe, effective, economical, and applicable. It is a good method for lithotripsy and can basically assist biliary scopy to achieve the purpose of removing residual stones, which is worthy of wide application.