Can gallstones be treated by lithotripsy? Biliary stones can be divided into cholesterol stones and bile pigment stones, and mixed stones according to the composition of the stones. Usually cholesterol stones are soft and are found in the gallbladder. Bile pigment stones are tougher and are usually found in bile duct stones. Unlike kidney stones, which are more commonly treated by lithotripsy, bile duct stones are relatively complex and the diameter of the bile ducts is significantly thinner than that of the ureter. Therefore, the effect of lithotripsy for biliary stones is often unsatisfactory and can cause serious complications, and lithotripsy is not clinically recommended for the treatment of biliary stones. Because the diameter of the distal bile duct is about 2-3 mm, lithotripsy can cause serious complications such as acute pancreatitis, acute cholangitis, and obstructive jaundice if the stone is embedded in the lower part of the bile duct with the bile remittance. In this case, the patient often needs surgery, which may transform the simple gallbladder stones into more complex common bile duct stones, which will significantly increase the treatment effect, treatment cost, postoperative complications, etc. It is not conducive to the patient’s remission and early recovery, so it is not the first recommended treatment for bile duct stones in clinical practice. However, for complex bile duct stones, holmium laser lithotripsy can be used as an intraoperative adjunctive treatment to help reduce the size of large stones and facilitate their removal.