Patients with initial or mild intrahepatic bile duct stones and sedimentary gallstones should preferably be treated with medication, but how to choose the appropriate surgical procedure for patients who must undergo surgery? Patients with intrahepatic bile duct stones should choose a reasonable surgical method according to the number and distribution of intrahepatic bile duct stones, the location and degree of hepatic stenosis, the pathological changes in the liver and the patient’s condition, in order to comply with the principle of “removing lesions, removing stones, correcting stenosis and clearing drainage. The principle of intrahepatic bile duct stone surgery is to remove the stones and bile duct strictures. What are the main types of surgical methods for intrahepatic bile duct stones: There are three main types – stone extraction, bile-intestinal anastomosis, and hepatectomy. Hepatectomy: It is a partial hepatectomy. For stones limited to liver segments and lobes, especially when the liver segments and lobes with stones are combined with fibrosis and atrophy, hepatectomy should be done. 2.Lithotripsy: In this procedure, the hepatobiliary duct is cut open to the left and right hepatic ducts, and the stones are removed as much as possible. 3.Biliary-intestinal anastomosis: that is, hepatobiliary stenosis incision, formation and biliary-intestinal anastomosis. For combined bile duct stenosis, it is necessary to prevent postoperative stenosis after incision, and these procedures are often not performed alone, but are often a combination of multiple surgical methods. The timing of surgery for primary hepatic bile duct stones: When primary hepatic bile duct stones are complicated by acute infection, after short-term non-surgical treatment, if the symptoms are not relieved, early surgery is recommended in principle. However, because of the complexity of primary hepatobiliary stones, the wide distribution of stones, and the frequent combination of intrahepatic bile duct stenosis, it is difficult to achieve complete surgery under emergency surgery conditions, and the reoperation rate is high. Therefore, the decision should be made on a case-by-case basis. If the condition permits, elective surgery is preferable.