Objective: To determine therapeutic efficacy in patients with intra- and extrahepatic stones by observation of the imaging evolution of the affected bile ducts before and after operation. Methods: The clinical records of 62 patients with intra- and extrahepatic calculi who met the criteria between 2006 to 2009 were selected, and then the patients were followed up and reexamined with MRI and magnetic resonance cholangiopancreatography (MRCP). The patients were divided, according to the types of surgery performed, into group A (8 cases, undergoing choledocholithotomy, T-tube drainage and partial liver resection), group B (16 cases, undergoing choledocholithotomy, T-tube drainage, partial liver resection, and choledochoscopic lithotomy via T-tube sinus tract) and group C (38 cases, undergoing choledocholithotomy, T-tube drainage, and choledochoscopic lithotomy via T-tube sinus tract). The imaging evolutions of each group were observed. The disease characteristic factors were assigned weighted values, according to which the scores of each group before and after operation were calculated to assess the therapeutic effects. Results: In the entire group, the pre- and postoperative rate of intrahepatic bile duct dilatation, extrahepatic bile duct dilatation and intrahepatic bile duct stricture was 98.4% vs. 79.0%, 90.3% vs. 67.7%, and 40.3% vs. 29.0% respectively, and recurrence rate was 9.7%. By comparison of the results before and after operation, the maximal diameters of the common bile duct in the three groups were all significantly reduced (all P<0.05), and the maximal diameters of the intrahepatic bile duct in group B and group C were markedly decreased (both P<0.05), and except in group A, it did not reach statistical significance (P>0.05). The postoperative scores in the three groups were all significantly decreased (all P<0.05), and the results of the pairwised comparison showed that the difference-value between pre- and postoperative scores in group B was significantly higher than that in group C (P<0.05). Conclusion: Most of the affected intra- and extrahepatic bile ducts do not recover into their normal state after operation and choledochoscopic lithotomy. Partial hepatectomy is an ideal procedure for intra- and extrahepatic stones.