1, Percutaneous common bile duct external drainage Patient lying flat on the operating table, routine disinfection and towel laying, take 8-9 intercostal axillary midline as the puncture point, 2% lidocaine local anesthesia successfully, use PTCD set 21G puncture needle horizontal pointing to the lower edge of the thoracic 11 vertebrae into the needle, withdraw the needle core, while injecting dilute contrast agent while withdrawing the needle until confirming the needle tip is located in the right hepatic duct near the common hepatic duct, there is dark green bile flowing out of the puncture needle, along the After repeated attempts to pass the guidewire through the obstructed section were unsuccessful, an 8F PTCD multi-lateral port external drainage tube was introduced via an 8F dilatation tube after dilatation, and the end of the drainage tube was well coiled in the upper part of the common bile duct, and dark green bile was drained About 50 ml of bile was drained. After fixing the drainage tube, a sterile dressing covered the puncture site. During and after the operation, the patient had no significant discomfort, and the patient returned to the ward safely. After the operation, anti-inflammatory, hepatoprotective and supportive treatment was given, and the bile duct drainage was continued. 2.Stent implantation The patient was lying flat on the operating table, routinely disinfected and toweled, the appropriate amount of contrast was injected along the PTCD external drainage tube, the bile duct was visualized, the micro-guide wire was introduced, and then the 5F guide wire was sent along the guide wire, the micro-guide wire was withdrawn, the mudskipper guide wire was introduced along the guide wire, and then the single-curved catheter was sent along the guide wire, the head end of the catheter was placed in the upper segment of the common bile duct, and the contrast was injected, and the intrahepatic bile duct was obviously dilated, and the common bile duct was also dilated. The upper part of the bile duct was also dilated, and the bile cyst duct and the gallbladder were visible, but the common bile duct far from the bile cyst duct was not visible. The hepatic duct was well coiled, drained bile, and fixed to the skin. There was no significant discomfort in the patient during the operation, and the patient returned to the ward safely.