There exist many different methods for diagnosing and treating hepatolithiasis, each with a particular set of advantages and disadvantages.While some diagnostic methods can provide stone-related features, such as size and composition, others reveal anatomy-related factors, such as bile duct stricture and structural variation, as well as secondary pathogeneses, all of which may affect treatment options and outcome.Thus, an appropriate treatment strategy must be selected according to the physical condition of each individual patient that is defined by the various diagnostic methods.Regardless of disease severity and progressive nature, however, surgery remains the primary treatment modality for removing bile duct stones.The individual patient′s comprehensive profile of stone-related and anatomic-/physiologic-related features must be taken into account to identidy the most appropriate and minimally-invasive technique that will achieve complete removal of the stones, relief of the obstruction, resolution of the lesion, and proper drainage.