Objective To investigate the effect of simultaneous treatment with laparoscopy combined with choledochoscopy or duodenoscopy in the surgery of patients with gallstones combined with extrahepatic bile duct stones. Methods Eighty-four patients with gallstones combined with extrahepatic bile duct stones admitted to a hospital in Henan Province from January 2020 to March 2021 were selected as study subjects. The patients were divided into the choledochoscopy group（n=42） and the duodenoscopy group（n=42） using the random number table method. Patients in the choledochoscopy group were treated with laparoscopy combined with choledochoscopy

and patients in the duodenoscopy group were treated with laparoscopy combined with duodenoscopy. The operation-related indexes（intraoperative bleeding

operation time） and stone removal results（stone residual

stone removal） were compared between the two groups. The time of gastric function recovery

first ambulation

and hospitalization of the 2 groups of patients was compared between the two groups. The levels of CD4

+

CD8

+

immunoglobulin A（IgA）

immunoglobulin G（IgG） and immunoglobulin M（IgM） before and 1 day after surgery were compared between the two groups. Complications

including abdominal bleeding

acute cholangitis

biliary leakage

and acute cholecystitis

were compared between the 2 groups at 7 days postoperatively. Results There was no statistically significant difference in intraoperative bleeding

operative time

stone removal rate and stone residual rate between the 2 groups（P

>

0.05）. The hospital stuys of the duodenoscopy group was shorter than the choledochoscopy g roup（P

<

0.05）. There was no statistically significant difference between the CD4

+

CD8

+

IgG

IgA and IgM levels in the 2 groups before surgery（P

>

0.05）. At 1 day after surgery

the CD4

+

CD8

+

IgG

IgA and IgM levels of patients in the 2 groups were lower than those before surgery

and the differences were statistically significant（P

<

0.05）

while the differences were not statistically significant（P

>

0.05） when comparing the duodenoscopy group with the choledochoscopy group. The total complication rate was 7.14% for patients in the duodenoscopy group and 9.52% for patients in the choledochoscopy group; there was no statistically significant difference in the complication rate between the 2 groups（P

>

0.05）. Conclusion Laparoscopy combined with choledochoscopy or duodenoscopy for simultaneous treatment of gallstones combined with extrahepatic bile duct stones can effectively relieve patients’ clinical symptoms and reduce the damage to cellular and humoral immune functions with high safety

but the hospitalization time of laparoscopy combined with duodenoscopy is shorter

and it is worthy of clinical promotion and application.