Objective To evaluate application value of choledochoscope and nasal bile duct drainage in the treatment of complicated liver echinococcosis combined biliary fistula.Methods The anthors retrospectively summarized and analyzed the clinical data of 144 patients with complicated liver echinococcosis combined biliary fistula.Treatment group (n 68) underwent liver hydatid internal capsule remove + intraoperative choledochoscopy and nose biliary drainage,control group (n-76) underwent the traditional internal capsule remove.The average length of hospital stay,residual cavity drainage catheter time,residual cavity bile leakage and residual cavity infection index of two groups were measured.Results The rate of T tube utilization,residual cavity infection,the incidence of biliary fistula in treatment group were significantly lower than the control group (P＜0.05).The length of hospital stay,the rate of discharge with drainage tube and the average length with tube were significantly less than control group (P＜0.05).Conclusion Intraoperative choledochoscopy and nasal bile duct drainage treatment of complicated liver hydatid,can reduce liver hydatid content residual and biliary fistula,reliable to deal with biliary fistula,part of a primary suture common bile duct,biliary fistula and residual cavity infection rate is low,patients recover quickly,shorter time of hospital stays,is worth popularizing.