Gallstones are a common disease, with an incidence of about 10% in China. Gallstones are one of the causative factors of bile duct (gallbladder) cancer. It is clinically proven that about 1/3 of patients with bile duct cancer have bile duct stones in combination; the incidence of intrahepatic bile duct tumor is about 2%-15% in cases of intrahepatic bile duct stones. Cholangiocarcinoma refers to malignant tumor of extrahepatic bile duct originating from the confluence of left and right hepatic ducts to the lower end of common bile duct. The incidence of bile duct cancer in China is less common than other malignant tumors of digestive tract, such as gastrointestinal and liver tumors, but the prognosis is poor. The average survival of palliative treatment or untreated is several months, rarely more than 1 year, and even surgical resection is rarely more than 5 years. Therefore, prevention and treatment of bile duct cancer and early diagnosis and early treatment are the keys to cure the disease. 1.Gallstones can induce bile duct cancer Why gallstones can easily induce bile duct cancer? It is because the recurring inflammation, stones and parasites in the bile are rubbing in the bile for a long time, which causes cancerous changes in the bile cells. Especially, recurrent gallstones can cause repeated infections in the bile ducts and symptoms such as inflammation and jaundice, which are more likely to induce bile duct cancer. Gallstones not only can induce the occurrence of cancer, but also may mislead doctors’ diagnosis of bile duct cancer and interfere with patients’ understanding of bile duct cancer. Nowadays, there are many patients who have bile duct cancer detected early through routine physical examination or through physical examination before stone surgery. However, many patients are still found to have cholangiocarcinoma only when painful symptoms appear in the middle and late stages of cancer, and some even mistake the stones combined with cholangiocarcinoma as simple stone disease, and mistake the obvious early symptoms such as poor appetite and hidden pain in upper abdomen as stomach disease, thus delaying the detection of cholangiocarcinoma. 2.Clinical manifestations The early clinical manifestations of cholangiocarcinoma are mainly discomfort in upper abdomen and developing jaundice, loss of appetite, emaciation, itching and so on. If gallstones and bile duct infection are combined, there may be chills and fever. If the cancer is located on one side of the hepatic duct, it is often asymptomatic at first, and obstructive jaundice appears only when it affects the opening of the opposite hepatic duct. Cancer of the middle bile duct without gallstone and infection is mostly painless, obstructive and fast developing jaundice. In case of tumor in the lower part of the common bile duct, an enlarged gallbladder may be palpable. If the tumor ruptures and bleeds, there may be black stool or positive fecal occult blood test and anemia. Because the early symptoms are very similar to stone disease, many patients may mistake the early symptoms of bile duct cancer as gallstone disease. 3.High-risk groups Who are clinically more prone to bile duct cancer? At present, experts believe that the following groups need special vigilance People above middle age, especially obese women, should have regular ultrasound examination and further examination and treatment if gallbladder inflammation, gallstones or polyps are found; patients with precancerous lesions, such as adenoma of gallbladder and adenomyosis of gallbladder, need active treatment of precancerous lesions. At the same time, patients with precancerous lesions, such as gallbladder adenoma and gallbladder adenomyosis, should be actively treated for precancerous lesions. At the same time, they should eliminate the triggers that may cause cancer, such as long-term consumption of high-fat food and alcohol abuse.