胆道残余结石可导致胆道梗阻、反复感染、肝功能损害，并远期增加胆管癌发生风险。为规范其诊疗行为，中国研究型医院学会微创外科学专业委员会组织多学科专家，遵循GRADE系统证据分级，采用改良Delphi法达成共识。本共识首先明确胆道残余结石的定义，系统梳理其发病率、临床特征及影像学诊断策略。在此基础上，针对胆囊/胆囊管残余结石、肝外胆管残余结石、肝内胆管残余结石三大类型，分别提出分层治疗路径；同时涵盖胆管炎、胆管狭窄等合并症的规范化处理原则。在治疗技术层面，明确肝切除、内镜取石、经皮经肝胆道镜等主要手段的适应证与选择时机，强调胆管狭窄矫正与胆汁通畅引流是实现远期疗效的关键环节。药物辅助治疗在调节胆汁代谢、改善临床症状方面具有综合管理价值。共识进一步就术后随访、患者教育与生活方式干预提出系统建议，形成覆盖诊疗全过程的闭环管理策略。本共识旨在为中国胆道残余结石的规范化、同质化诊疗提供循证依据，提升临床决策科学性与改善患者远期预后效果。

Residual biliary stones can potentially lead to biliary obstruction, recurrent infections, hepatic dysfunction, and an increased long-term risk of cholangiocarcinoma. To standardize diagnostic and management strategies, the Minimally Invasive Surgery Committee of the Chinese Research Hospital Association convened a multidisciplinary panel of experts. This consensus was developed using the GRADE evidence grading system in conjunction with the modified Delphi method. The document begins by defining residual biliary stones and systematically examines their epidemiology, clinical manifestations, and imaging diagnostic strategies. Based on this foundation, stratified treatment algorithms are proposed for three main categories: residual stones in the gallbladder/cystic duct remnant, the extrahepatic bile duct, and the intrahepatic bile ducts.Standardized management principles for associated conditions, such as cholangitis and biliary strictures, are systematically incorporated into the framework. The consensus delineates the indications and optimal timing for various techniques, including hepatectomy, endoscopic stone extraction, and percutaneous transhepatic cholangioscopy, while emphasizing the importance of correcting biliary strictures and ensuring adequate drainage as critical determinants of favorable long-term outcomes. Furthermore, adjunctive pharmacotherapy is acknowledged for its role in modulating bile metabolism and alleviating symptoms, thereby serving as an essential component of comprehensive management. The consensus also provides systematic recommendations for postoperative surveillance, patient education, and lifestyle interventions, thereby establishing a closed-loop management strategy that encompasses the entire diagnostic and therapeutic continuum. This consensus offers evidence-based guidance aimed at harmonizing and rationalizing clinical decision-making, ultimately enhancing therapeutic precision and improving long-term prognoses for patients with residual biliary stones in China.