Abstract objective To compare and analyze the effect of full laparoscopy and endoscopy combined with laparoscopy for choledocholithiasis with benign gallbladder diseases, and to explore the best minimally invasive treatment. Methods The clinical data of 122 patients with choledocholithiasis and benign gallbladder diseases treated in Sichuan Mianyang 404 Hospital during the period of May 2014 to May 2017 was retrospectively analyzed. According to the operative method, patients were divided into laparoscopic cholecystectomy combined with common bile duct exploration group (LC+LCBDE, n=75) and endoscopic sphincterotomy combined with LC group (EST+LC, n=47). LC+LCBDE group was further divided into transcystic common bile duct exploration group (LTCBDE, n=30), biliary primary suture group (n=21), and T-tube drainage group (n=24). The perioperative results of each group were compared and analyzed. Results Compared with EST+LC group, LC+LCBDE group had no statistical difference (P>0.05) in operation duration, postoperative fasting time and incidence of postoperative complications, but the intraoperative blood loss [(22.36±5.89) mL vs (18.74±6.58) mL],the postoperative hospitalization time [(7.90±2.91) d vs (5.40±2.51) d], and the total cost [(19 467.72±1 916.39) yuan vs (24 882.89±2 477.21) yuan] between two groups were statistically significant different (P<0.05). In LC+LCBDE group, the operation duration and intraoperative blood loss in LTCBDE group and biliary primary suture group were not significantly different from that in T-tube drainage group (P>0.05); the postoperative fasting time [(28.44±10.69) h, (32.67±12.61) h vs (33.94±11.75) h], abdominal drainage time [(2.02±0.64) d,

(2.19±0.71) d vs (3.68±0.94) d], postoperative hospitalization time [(5.10±1.04) d, (6.61± 1.16) d vs (9.81±1.26) d] in group LTCBDE and biliary primary suture group were shorter than those in T-tube drainage group (P<0.05), the hospitalization cost [(18 743.57±1 952.64) yuan, (21 035.94±2 268.68) yuan vs (19 242.90±1 549.71) yuan] were less than that in T-tube drainage group (P<0.05); the incidence of postoperative complications (0, 19% vs 25.0%) were also lower than that in T-tube drainage group, and there was a statistically significant difference between LTCBDE group and T-tube drainage group (P<0.05). Conclusion (1)Compared with the endoscopy combined with laparoscopy, full laparoscopy avoids sub-surgery, with wider indications, less postoperative complications, and less hospitalization costs, which is worth recommending; (2)In full laparoscopy, LTCBDE and primary suture of bile duct can achieve the purpose of one-time closure of the bile duct, allowing patients to obtain greater treatment benefits, clinically, preference should be given to the specific conditions of cystic duct or

common bile duct.