The use of laparoscopy, cholangioscopy, and duodenoscopy for the treatment of biliary system stones has become a trend in recent years, but any one of these methods has its limitations and shortcomings when used alone. Combining the three scopes to treat biliary system stones can complement each other’s strengths and bring the advantages of minimally invasive techniques to their fullest. Combined laparoscopy and choledochoscopy Laparoscopic cholecystectomy (LC) + transcystic ductal exploration for common bile duct stone extraction. laparoscopic stone extraction via the cystic duct during LC can solve two problems in one operation, and its postoperative complications and recovery process are similar to LC. However, this procedure is easily limited by the size, length, and course of the gallbladder duct diameter, as well as by the size and number of stones, and only about 30% of patients are suitable for this procedure. LC + laparoscopic common bile duct exploration (LCBDE) is currently considered the best treatment for common bile duct stones (CBDS) because of its high success rate, minimal trauma, and few complications. The patient position and the location of the abdominal wall operating hole are the same as for laparoscopic cholecystectomy, with LC first, followed by separation and exposure of the anterior wall of the common bile duct. After confirmation by puncture, the common bile duct is incised along the longitudinal axis of the common bile duct about 1.0 cm, and the choledochoscope is placed through the subxiphoid puncture hole and entered into the bile duct. The results of the combined laparoscopic and choledochoscopic surgery and open surgery were compared, and all stones were removed in both groups, and there was no significant difference in the operation time, but the average number of hospital days in the combined surgery group was significantly shorter than that in the open surgery group. The advantages were obvious. With the development of endoscopic technology and lithotripsy instruments, transduodenoscopic choledocholith extraction has become one of the main means of common bile duct stone treatment. Duodenoscopic stone extraction requires duodenal papillotomy (EST) or balloon dilation (EPBD). It is more controversial whether laparoscopy and duodenoscopy for choledocholithiasis should be performed simultaneously or in separate phases. Generally, there are two stages, especially in cases of combined biliary pancreatitis and obstructive cholangitis. That is, in patients with suspected or confirmed common bile duct stones, duodenoscopic retrograde cholangiopancreatography (ERCP) is performed before LC, and duodenoscopic stone extraction and nasobiliary drainage is performed with a success rate of more than 95%, and LC is performed at a later stage after the condition is stabilized. Combined laparoscopy and duodenoscopy is indicated for gallbladder stones combined with common bile duct stones or duodenal papillitis, duodenal papillary stenosis and their resulting patients with biliary pancreatitis and obstructive cholangitis. The combination of laparoscopy, choledochoscopy and duodenoscopy is often complex, and it is sometimes difficult to achieve minimally invasive treatment with one or two endoscopes alone. Preoperatively, endoscopic papillotomy for stone extraction and nasobiliary drainage (ENBD) is completed using duodenoscopy, LC and common bile duct dissection are performed laparoscopically, and cholangioscopy is completed with biliary exploration for stone extraction and flushing of the bile duct followed by suturing of the common bile duct in stage I or placement of T-tube drainage. The combined use of laparoscopy, cholangioscopy and duodenoscopy to complete LCBD gives full play to the advantages of each scope, which not only improves the accuracy of diagnosis, but also reduces the residual stone rate by removing as many bile duct stones as possible, and simplifies the operational difficulties of gallstone treatment, and improves the success rate of minimally invasive treatment.