Patients with small bile duct stones and no associated clinical symptoms do not need to undergo surgery, which is traumatizing and risky, and immediate surgery is needed for large bile duct stones with obvious symptoms. Bile duct stones that are small and have no associated clinical symptoms usually do not require surgical treatment and can be treated with medication, such as ursodeoxycholic acid capsules, which can promote stone expulsion. Surgical treatment for cases without indications for surgery can cause more harm than good. Currently, surgical treatment, such as choledochotomy, endoscopic retrograde cholangiopancreatography and lithotripsy, should be performed in cases with obvious symptoms and large stone size. Whether or not to undergo surgery for bile duct stones depends on the actual situation, and professional doctors should improve the relevant examinations, make a comprehensive judgment, and choose the most appropriate treatment plan.