Based on the location of the stones, bile duct stones above the confluence of the left and right hepatic ducts are called intrahepatic bile duct stones, and those below are called extrahepatic bile duct stones. Extrahepatic bile duct stones can originate in the bile duct system or be discharged from the gallbladder to the bile duct, the former being called primary extrahepatic bile duct stones and the latter secondary extrahepatic bile duct stones. The typical symptoms of extrahepatic bile duct stones are abdominal pain, chills and high fever and jaundice, called Charcot triad. 1. Abdominal pain: paroxysmal colic in the right upper abdomen or under the glabella, radiating to the right shoulder and back. It is accompanied by nausea and vomiting. Often triggered by eating greasy food and change of body position. 2, chills and high fever: accounting for 2/3, occurring after abdominal pain, associated with biliary tract infection, toxins or bacteria into the blood. 3, jaundice: jaundice appears 1~2 days after abdominal pain, chills and hyperthermia. 4.Severe cases present with altered consciousness or shock, which are manifestations of acute obstructive cholangitis or severe cholangitis and require emergency surgery. 5. Examination shows subxiphoid and right upper abdominal pressure pain and percussion pain in the liver area. Sometimes an enlarged gallbladder can be palpated. 6.B ultrasound and CT show common hepatic duct or common bile duct stones, and liver function shows elevated direct bilirubin. The clinical manifestations of intrahepatic bile duct stones can be diverse depending on the location of the lesion. When stones descend into the extrahepatic bile duct causing biliary obstruction or acute inflammation, manifestations of extrahepatic bile duct stones such as epigastric colic, chills, high fever and jaundice may occur. If the stone is not dislodged into the extrahepatic bile duct, sometimes it may be complicated by infection, and septic symptoms such as chills and high fever may occur, and in severe cases, toxic shock. However, the patient may not present with abdominal cramps and jaundice, so it is often misdiagnosed. Some intrahepatic bile duct stones cause shrinkage of liver tissue in the obstructed area due to long-term obstruction of the intrahepatic bile duct. The unobstructed normal liver tissue compensates for the hyperplasia, the compensated part enlarges, the atrophic part shrinks, the liver is deformed, and the gallbladder is displaced.