The risk of choledocholithiasis in 86-year-old people is relatively high, and the possible risks include: anesthesia-related risks, comorbid underlying diseases, decreased immunity, and coagulation disorders. 1. Anesthesia-related risks: general anesthesia is often required for choledochal stone surgery, and 86-year-old people are less tolerant to anesthesia drugs than middle-aged and young people, so the risk of various anesthesia accidents will be greatly increased. 2. Comorbid underlying diseases: 86-year-old people are often comorbid with different underlying diseases, such as hypertension, diabetes mellitus, chronic kidney disease, liver disease, etc. These underlying diseases may induce intraoperative accidents, such as intraoperative fluctuation of blood pressure, acute heart failure, acute renal failure, etc., which increases the risk of surgery. 3. Decreased immunity: 86-year-olds have mostly decreased immunity, and the risk of postoperative co-infections is greatly increased, such as incision infections, lung infections, and urinary tract infections. 4. Coagulation dysfunction: many elderly people have different degrees of coagulation dysfunction, which may induce intraoperative or postoperative hemorrhage, disseminated intravascular coagulation, postoperative deep vein thrombosis of the lower extremities, etc., which may endanger the patient’s life in serious cases. The risk of choledocholithiasis surgery for 86-year-olds is much higher than that of young people. Patients are advised to carefully consider whether to undergo the surgery by communicating with their treating doctors and requesting a consultation with doctors from related departments if necessary, and then carefully assessing the risk of the surgery.