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胆道外科常见的急腹症包括急性胆囊炎和急性胆管炎。急性胆囊炎发病率高，腹部超声已成为首选影像学检查方法。病情评估和严重程度分级用于指导治疗方案的制定。轻度急性胆囊炎，早期首选腹腔镜胆囊切除术。重度急性胆囊炎，应积极支持治疗，改善症状后，择期行胆囊切除手术。对于不能耐受手术风险、保守治疗无效的重度胆囊炎患者，应及时行胆囊引流治疗。急性胆管炎发病急，病死率高。磁共振胰胆管成像是重要的影像学检查方法。急性胆管炎的治疗原则是早期进行胆道减压、抗生素应用和一般支持治疗。常用的胆道减压方法包括经皮经肝胆管穿刺置管引流、内镜下经十二指肠乳头胆管引流、内镜超声引导下胆管引流、手术放置T管引流等。“,”Acute cholecystitis and acute cholangitis are common acute abdomen in biliary surgery. The morbidity of acute cholecystitis is high, and abdominal ultrasound has become the first choice for imaging examination. Disease assessment and severity grading are used to guide the formulation of treatment plan. Early laparoscopic cholecystectomy is the first choice for mild acute cholecystitis. Supportive treatment should be used in patients with severe acute cholecystitis to improve symptoms for elective cholecystectomy. For patients with severe cholecystitis who can not tolerate the risk of surgery and have no effect on conservative treatment, gallbladder drainage should be performed in time. Acute cholangitis is an acute disease with high mortality. Magnetic resonance cholangiopancreatography is an important imaging examination. The treatment principle of acute cholangitis is early biliary decompression, antibiotic application and general supportive treatment. The common methods of biliary decompression include percutaneous transhepatic cholangiography drainage, endoscopic duodenal papillary bile duct drainage, endoscopic ultrasound-guided biliary drainage, and surgical placement of T-tube drainage.