With the development of minimally invasive surgery, the treatment of gallbladder stones combined with common bile duct stones has changed from open cholecystectomy and choledochotomy to the combined treatment of minimally invasive modalities such as duodenal papillotomy for stone extraction (EST), laparoscopic cholecystectomy (LC), laparoscopic biliary exploration (LCBDE), laparoscopic transcystic bile duct exploration (LTCBDE), and choledochoscopic stone extraction. These three minimally invasive combined treatment modalities for gallbladder stones combined with common bile duct stones are described below. EST+LC: It is the most widely used method. The advantage is that the common bile duct stones are first removed by endoscopy and the nasobiliary duct is placed, and the second stage of LC surgery is treated like gallbladder stones without combined common bile duct stones, with short operation time and small abdominal harassment. If the endoscopic papillotomy is replaced by papillary dilation (EPBD) can reduce the incidence of duodenal perforation, bleeding, and disrupted duodenal papillary sphincter function, but it may increase the incidence of post-ERCP pancreatitis (PEP). In my opinion, the LC+EPBD protocol is relatively safe and should be the preferred method as it can reduce the incidence of PEP by reducing the number of intubations during endoscopic operation, selective bile duct intubation, avoiding pancreatic duct intubation and repeated hypertensive drug injection as well as guidewire-guided intubation instead of contrast agent. Second, LC+LCBDE should be a direct continuation of the open surgical approach, with a wider range of adaptations and less stone remnants as well as recurrence. Some reports suggest that the application of LC+LCBDE for gallbladder stones combined with common bile duct stones is safe and effective. However, the retention of T-tube directly affects the patient’s postoperative recovery, and the time to perform imaging and extubation is inevitably prolonged because laparoscopy interferes less with the abdominal cavity than open laparoscopy, and the postoperative T-tube sinus tract formation is relatively longer. It takes 4-6 weeks for postoperative imaging and extraction for those without stones, and 8 weeks for choledochoscopic extraction if there are stone remnants, which inevitably prolongs the postoperative recovery time of patients and affects their quality of life. Of course, there are reports of one-stage suturing after LCBDE, but it requires patency of the lower bile duct, stone removal, and bile duct dilatation to a certain degree; some studies point out that the indications for LCBDE and one-stage suturing of the common bile duct are: (1) stones in the common bile duct have been removed; (2) the diameter of the common bile duct is ≥0.8 cm, and there is no stenosis in the lower bile duct; (3) there is no obvious acute inflammatory edema in the wall of the common bile duct; ( 4) those with good opening and closing of the duodenal papilla and distal patency as observed by cholangioscopy; (5) those with nasobiliary drainage tube (ENBD) placed by ERCP before surgery. Third, in theory LC+LTCBDE is more ideal, using ultra-fine choledochoscopy, transcystic ductal exploration for stone extraction, and combined with intraoperative cholangiography, which can prevent stone remnants and eliminate the need for retention of T-tube. Cases treated with this approach have been reported to shorten the postoperative hospital stay and reduce hospital costs without increasing the incidence of complications such as stone remnants, recurrence, and bile leakage. However, not all cases are suitable for LC+LTCBDE. Due to the inaccessibility of the choledochoscope due to the diameter of the cystic duct, the use of a 0.2-0.4 cm microdissection of the common bile duct to facilitate choledochoscopic access and interrupted simple suturing with 4-0 absorbable thread after stone extraction has been reported to solve the problem of inaccessibility of the choledochoscope in some cases, but is not applicable in all cases. Referring to the relevant literature reports and our experience, we believe that LTCBDE can be considered in the following cases: (1) bile duct diameter greater than 0.5 cm; (2) common bile duct stones up to 1.0 cm in diameter; (3) number of gallbladder stones less than 10. And other treatments are recommended in the following cases: (1) severe gallbladder triangle adhesions; (2) thin gallbladder duct; (3) Mirrizzi syndrome; (4) more and larger stones in the common bile duct. In general, we believe that minimally invasive treatment modalities for gallbladder stones combined with common bile duct stones have their own advantages and should be tailored to the actual situation of each case. With the development of minimally invasive techniques, the emergence of more flexible laparoscopic, duodenoscopic and choledochoscopic instruments, and the application of more delicate laparoscopic suturing techniques, all the above techniques should better reflect the concept of minimally invasive and rapid recovery.