In advanced stage lung metastasis of intrahepatic bile duct cancer with fluid accumulation in chest cavity and dyspnea, chest drain should be kept to relieve dyspnea. The presence of pleural fluid in advanced lung metastasis of intrahepatic cholangiocarcinoma is often due to the presence of lung or pleural metastasis, which leads to the accumulation of pleural fluid, compresses lung tissues, and produces dyspnea. Timely chest drainage, after the amount of pleural fluid is reduced, and at the same time, intrathoracic perfusion chemotherapy can be given, the lung compression is reduced, which will relieve the patient’s symptoms of dyspnea. Chest drainage must be controlled to avoid excessive speed, which can cause acute pulmonary edema and aggravate dyspnea. Those who are older and have more underlying diseases should also pay attention to heart function and reduce the amount of infusion to reduce the burden on the heart. Therefore, when intrahepatic cholangiocarcinoma presents with dyspnea caused by pleural fluid, drain the pleural fluid in time and avoid excessive speed.