Stones are the most common disease seen affecting the biliary tree. The origin most commonly is the gallbladder. They present in a variety of ways reflecting the complications of this disease. If large they can cause chronic pain, indigestion to fatty food and bloating. This represents symptoms of gallbladder chronic inflammation and dysfunction. If the pain is prolonged and sharp, it is a symptom of acute gallbladder inflammation. If the stones are small, then they can migrate through the duct system, to the duodenum. Passing through the common duct, they can cause colic like pain called biliary colic. If a stone obstructs the common duct, it will cause yellowish discoloration of the eyes and skin. That requires an urgent decompression of the common bile duct usually with upper endoscopy by our gastroenterologist, and widening of the duct opening in the duodenum in a procedure called ERCP (Endoscopic Retrograde Cholangio-Pancreaticography). If the stones obstruct the pancreatic duct at its meeting point with the common bile duct, then it can cause inflammation of the pancreas. This usually present with severe abdominal pain and back pain, associated with repeated vomiting. This requires fasting, hydration with intravenous fluids till the inflammation subsides. ERCP is done if suspected stone is still present. All the above requires removal of the gallbladder, examining the duct system for the presence of stones, and removing them if present, all of which can be done laparoscopically through minimally invasive techniques.