Laparoscopic combined with choledochoscopic transcystic duct choledocholith extraction + cholecystectomy is the best way to treat gallbladder stones and secondary stones in the common bile duct in a minimally invasive manner. However, because this procedure requires high technical requirements of laparoscopy and choledochoscopy, it is difficult to be performed in many hospitals at present, so it is not the first choice of treatment for most doctors and patients so far. I have been exploring the implementation of this procedure since 2007 and have successfully completed hundreds of cases so far without surgical complications, and all patients have recovered successfully. I have also given lectures on this procedure at national biliary surgery conferences and related training courses, and it has been well received by the industry. This article is dedicated to introduce this minimally invasive surgical approach to a wider audience. Many patients have gallbladder stones that fall from the gallbladder into the common bile duct, forming secondary stones in the common bile duct. The principle of this procedure is to remove the secondary bile duct stones from the original path where they fell and remove the gallbladder under laparoscopy, which not only avoids the bile duct damage caused by bile duct incision, but also avoids leaving the drainage tube (T-tube) in the bile duct. The procedure time, cost and postoperative recovery are similar to those of simple laparoscopic cholecystectomy. The operation time is basically about one hour, the cost is usually about 15,000 RMB, and the patient can be discharged after 2-4 days of hospitalization without any drains, which significantly improves the quality of life after the operation. Another great advantage of this procedure is that it does not damage the bile duct and preserves the function of the lower bile duct sphincter at the same time. In the last two years, I have newly adopted laparoscopic balloon dilatation of the bile ducts and bile ductoscopic plasma shock wave lithotripsy techniques, which have enabled the successful performance of many cases that were previously difficult to perform, in addition to many difficult patients with a history of combined upper abdominal surgery, making the scope of surgical indications even wider. This procedure has now become the preferred minimally invasive treatment for gallbladder stones and secondary common bile duct stones at Peking University Third Hospital. However, up to now, most doctors recommend removing the common bile duct stones first with duodenoscopic lower biliary sphincterotomy (ERCP+EST), and then resting for a few days to a month before laparoscopic cholecystectomy to complete the minimally invasive treatment. The above treatment has the following disadvantages: 1. To a certain extent, the function of the lower bile duct sphincter (sphincter of Oddi) is permanently destroyed, so that the natural barrier function of the bile duct, sphincter of Oddi, is lost, and after the operation, food and gastrointestinal fluid may reflux into the bile ducts inside and outside the liver, which increases the number of bacteria in the bile ducts. The risk of cholangitis and bacteraemia is significantly increased and the patient will develop high fever. Chills, and jaundice. Severe cases can be life-threatening. In addition, the potential medium- and long-term risks are not yet predictable. It is not worth the cost to easily destroy the function of the biliary sphincter because of a few small bile duct stones. 2. Patients need to face two invasive operations, and the corresponding pain and potential risks are increased. 3, High cost of treatment. The whole hospitalization cost of this treatment is at least about 10,000 yuan higher than the laparoscopic transcystic ductal bile duct extraction + cholecystectomy used in our hospital. On October 18, 2014, the North Medical College will hold a national training course on minimally invasive techniques and new advances in biliary surgery. At that time, I will explain in detail the technical points and details of this surgical approach to my fellow biliary surgeons nationwide with several cases, and I also hope that more surgeons will master this minimally invasive surgical approach as soon as possible for the benefit of more patients.