Abstract: Objective To explore the optimal laparoscopic minimally invasive surgery for the treatment of patients with choledocholithiasis and cholecystolithiasis. Methods 500 patients with choledocholithiasis and cholecystolithiasis were recruited in our hospital between June 2013 and June 2016,and 234 of them received laparoscopic common bile duct exploration（LCBDE） and 266 received laparoscopic transcystic stone extraction （LTSE）. The patients in LCBDE group was treated with laparoscopic cholecystectomy（LC） plus LCBDE and T tube drainage,and the patients in LTSE group was given LC and LTSE. The number of calculus,the diameters of stones,the removal rates of stones,the periods of operations,the times of first exhaust,the hospital stays,and the postoperative complications and recurrence rates of gallstones were compared between the two groups. Results The number of stones in the LCBDE group was greater than that in the LTSE group [（4.6±1.7） vs. （3.1±2.4）,P<0.05],and the stone diameter in the LCBDE group was larger than that in the LTSE group [（11.8±5.40） mm vs.（5.2±2.2） mm,P<0.05];the operative time,first exhaust time and hospital stays were（114±27） min,（3.4±1.3） d and （7.1±3.2） d,respectively in the LCBDE group,much longer than those in the LTSE group[（73±21） min,（2.2±0.9） d and（3.5±1.8） d,respectively,P<0.05];there was no significant difference in the removal rates of stones between the LCBDE group and the LTSE group（94.9% vs.94.7%,P>0.05）;the total incidence rate of complications was 24.4% in the LCBDE group,significantly higher than that in the LTSE group（10.9%,P<0.05）;during the 1 year of follow-up,the stone recurrence rate in the LCBDE group was 4.7%,much higher than that in the LTSE group（1.5%,P<0.05）. Conclusions The application of LC plus LTSE in treatment of patients with choledocholithiasis and cholecystolithiasis have a good efficacy with fast recovery,short hospital stays,and low morbidity of complications and long-term stone recurrence.

Key words: Choledocholithiasis, Cholecystolithiasis, Common bile duct exploration, Transcystic stone extraction, Therapy