Abstract: objective To analyze the safety and efficacy of laparoscopic cholecystectomy (LC) combined with laparoscopic common bile duct exploration (LCBDE), endoscopic cholangiopancreatography/ endoscopic sphincterotomy (ERCP/EST) combined with LC for patients with cholecystolithiasis and extrahepatic bile duct stones. Methods The clinical data of patients with cholecystolithiasis and extrahepatic bile duct stones who were treated in Affiliated Hospital of Xuzhou Medical University from January 2015 to August 2018 were analyzed. The operation time, hospital stay, hospitalization expenses, rate of residual stones, incidence of complications and recurrence of stones were compared between the two groups. Results There were no significant differences between the two groups in age, gender, WBC, TBIL, DBIL, AST, ALT，diameter of common bile, chronic diseases and abdominal surgery history. The operation time (150.68±55.23) min VS (126.81±29.10) min in the LC+LCBDE group was larger than that in the ERCP/EST+LC group, but the hospitalization expenses (37193.85±10522.50) VS (40541.04±8881.93) and the incidence of long-term complications (17.4%)VS(29.4%) was smaller than that in the ERCP/EST+LC group, and the difference was statistically significant (P<0.05). There was no significant difference between the two groups in the hospital stay (15.45±7.14) d VS (14.71±5.09) d and the incidence of postoperative complications (10.9%)VS(14.7%) (P>0.05). Conclusions Both LC+LCBDE and ERCP/EST+LC are effective methods for the treatment of cholecystolithiasis with extrahepatic bile duct stones. LC+LCBDE has lower cost and higher cost performance. In addition, it protects the function of the sphincter of the nipple, reduces the incidence of long-term complications, and is of higher safety. It should be the preferred surgical method for appropriate patients