Recently, Dr. Li, chief of the Biliary and Pancreatic Surgery Department, successfully completed a case of ERCP extraction of choledochal stones with full visceral inversion in only 40 minutes, which is the only 9 cases reported in the world. The patient, a 55-year-old female with a gallbladder removed for more than 10 years, had an episode of right upper abdominal pain and fever with mild jaundice one and a half months ago, and an upper abdominal MRI showed a stone in the common bile duct. Because of the total visceral inversion, the treatment team reviewed the relevant literature, made a full technical discussion and multiple sets of clinical preplanning before deciding to perform the procedure in the supine position. During the operation, the patient overcame many unfavorable factors such as backward facing monitor, reversed access, curved mirror position, “mirror” intubation and incision, reversed radiographic images, difficulty in accessing accessories, opposite direction of stone extraction and large stones, etc. The operation was completed successfully within the preset structure. The patient recovered well after the operation and was discharged on the 4th day. The first choice of ERCP for simple common bile duct stones has been routinely performed in our department for more than 10 years, with an average annual implementation of more than 400 cases, an average operation time of 27 minutes, a successful intubation rate of nearly 97%, and a serious complication rate of only 1%. In recent years, we have also realized the daytime ERCP, opened a green channel for emergency ERCP, and carried out the full-coated metal stent technique to correct benign stenosis of the common bile duct. In addition, the team has performed single-port laparoscopic cholecystectomy for gallbladder stones and polyps with remarkable cosmetic results. For acute biliary tract infection, external puncture drainage and ERCP internal drainage are used followed by a combination of laparoscopic, choledochoscopic and duodenoscopic techniques to realize the whole minimally invasive treatment in stages, basically abandoning the previous traumatic open surgery. At present, the overall success rate of minimally invasive surgery for extrahepatic bile duct stones is over 92%, and even for patients after upper abdominal surgery, minimally invasive treatment can be achieved.