Choledocholithiasis is divided into primary choledocholithiasis and secondary choledocholithiasis, which is a common and frequent clinical disease with complex clinical manifestations and rapid changes in condition, including abdominal pain, jaundice, chills, fever, and even symptoms of infectious shock such as decreased blood pressure, delirium and coma. At present, there are two types of treatment methods for common bile duct stones: surgical methods and non-surgical methods. The endoscopic retrograde cholangio-pancreato- graphy (ERCP) is performed by inserting the duodenum into the descending duodenum, finding the main duodenal papilla (hereinafter referred to as the papilla), inserting a catheter into the biopsy duct to the opening of the papilla, injecting a contrast agent and then taking an X-ray to show the pancreaticobiliary duct. On the basis of ERCP, interventions such as duodenal papillary sphincterotomy (EST), endoscopic nasobiliary drainage (ENBD), endoscopic endobiliary drainage (ERBD) can be performed, especially for patients with primary or secondary common bile duct stones, without gallbladder stones and intrahepatic bile duct stones, which are more suitable for ERCP+EST. For patients with acute obstructive septic cholangitis (AOSC), emergency ERCP+EST+ENBD has satisfactory clinical results. Low risk and rapid recovery. Duodenoscopic technique is minimally invasive, less painful for patients, less complications and mortality, faster recovery, and does not require general anesthesia, and is not limited by peribiliary adhesions after multiple surgeries and the patient’s old age and frailty. It is superior to surgical cesarean operation and non-surgical treatment methods combining Chinese and Western medicine, and has many advantages such as avoiding surgical pain and saving cost, etc. It is favored by medical workers and patients, and has become the primary treatment for common bile duct stones. Since 1999, our gastroenterology department has completed more than 2000 cases of therapeutic ERCP, with a success rate of more than 95%, among which the oldest is 91 years old.