The traditional treatment for bile duct stones is an invasive and painful open surgery with placement of a biliary T-tube for drainage for at least 2 weeks. The previous laparoscopic bile duct exploration approach was to remove the stone through the anterior wall of the common bile duct and then place a T-tube for drainage for at least 4 weeks. In the previous day, a patient with an embedded stone in the lower bile duct could not be successfully resolved orally by minimally invasive biliary obstruction. With the latest method of choledochotomy through the common bile duct, a combination of laparoscopic and choledochoscopic choledochotomy with intraoperative plasma lithotripsy and cholecystectomy was successfully performed for this patient. The traditional treatment for bile duct stones used to be: open surgery, traumatic and painful, most patients had to be put down with gastric and urinary catheters, unable to move normally on the floor for 2-3 days after surgery, and bile duct T-tube placed for drainage for at least 2 weeks after surgery. In recent years, laparoscopic and choledochoscopic combined bile duct exploration (LCBDE), as one of the advanced techniques for the treatment of common bile duct stones internationally, is one of the least invasive methods for the treatment of common bile duct stones, and its efficacy is certain. LCBDE is a good choice especially for patients with complex bile duct stones where ERCP is unsuccessful, and for younger patients. There are two main surgical approaches that are popular abroad today, transcystic ductotomy and cystic duct route. The transcystic ductal approach is the least invasive for the patient, but the transcystic ductal approach has more factors affecting success and requires more skill and equipment. The previous laparoscopic bile duct exploration method was to remove the stone through an anterior choledochotomy followed by placement of a T-tube for at least 4 weeks. The latest method of transcystic ductal exploration for stone extraction is a combined laparoscopic and choledochoscopic bile duct exploration and cholecystectomy, which is done through the cystic duct without a bile duct T-tube, allowing intraoperative plasma lithotripsy and eliminating the need to carry a drain for at least 4 weeks after surgery in these patients. Transcystic duct laparoscopic choledochoscopy combined with common bile duct exploration and stone extraction is particularly suitable for patients under 60 years of age, preserving the normal function of the human papillary sphincter and eliminating the factor of recurrence of bile duct stones after sphincterotomy. Thanks to the advances in manufacturing technology providing doctors with more tools to benefit patients, making minimally invasive surgery more minimally invasive and personalized.