Objective: To investigate the diagnosis and surgical treatment of pancreatic duct stones. Methods: The clinical data of 43 patients undergoing surgical procedure for pancreatic duct stones during the past 6 years in our hospital were retrospectively analyzed. Results: The male-to-female ratio among the patients was 2:1. The main symptom of the patients was upper abdominal pain and some of them had accompanied lower back pain. The diagnosis of all cases was confirmed by imaging examinations. Thirty-four cases underwent pancreatic lithotomy with a side-to-side Roux-en-Y pancreaticojejunostomy (two cases had a synchronous resection of the body and tail of the pancreas), five cases underwent duodenum-preserving pancreatic head resection, and pylorus-preserving pancreaticoduodenectomy, classical Whipple procedure and resection of the body and tail of the pancreas with splenectomy were performed in one case each, respectively, and unresectable tumor was found in one case during surgical exploration. The period of follow-up ranged from 5 months to 6 years. Of the 43 patients, 23 cases had their abdominal pain completely alleviated and 18 cases had varying degrees of improvement. Conclusion: Imaging examination is the main modality for diagnosis of pancreatic duct stones, and the surgical procedure for this condition should be individualized to the specific patient. Pancreatic lithotomy with a side-to-side Roux-en-Y pancreaticojejunostomy is the main operative procedure for pancreatic duct stones, and other procedures such as duodenum-preserving pancreatic head resection or distal pancreatectomy may be recommended depending on the patient's situation.