Objective To investigate the effect of endoscopic retrograde cholangiopancreatography (ERCP) combined with laparoscopic cholecystectomy (LC) and traditional open cholecystectomy on cholecystolithiasis complicated with choledocholithiasis and the effect of stress response. Methods Totally 280 patients with cholecystolithiasis and choledocholithiasis who came to our hospital from January 2015 to February 2018 were selected as the research objects.The patients were divided into the observation group and the control group by different surgical ways

with 140 patients in each group.The control group was treated with routine open surgery

while the observation group was treated with ERCP combined with LC. The efficacy and the changes of adrenalin (A)

norepinephrine (NE)

adrenocorticotropin (ACTH) and cortisol (COR) levels before and after surgery were compared between the two groups. Results The success rate of ERCP combined with LC was 97.14%. Compared with the control group

the operation time of the observation group was slightly higher

but there was no significant difference (P>0.05). The bleeding volume

anal exhaust time

recovery time of bowel sounds and hospitalization time in the observation group were significantly less than those in the control group with significant difference (P<0.05)

while the complication rate in the observation group was significantly lower than that in the control group (P<0.05). Before operation

there was no significant difference in COR

ACTH

NE and A levels between the two groups (P>0.05). And the above levels in the two groups were significantly higher after operation (P<0.05). Compared with the control group

the COR

ACTH

NE and A levels after operation in the observation group were significantly higher (P<0.05).Eight months after operation

the scores of subjective symptoms

emotional scores and GLQI in the observation group were significantly higher than those in the control group (P<0.05)

and there was no significant difference in the scores of social and physiological functions (P>0.05). Conclusion ERCP combined with LC in the treatment of choledocholithiasis complicated with cholecystolithiasis has the advantages of good curative effect

less trauma and quick recovery.Compared with traditional open surgery

it has less stress reaction and higher quality of life.