Objective To explore the safety and therapeutic effect of endoscopic retrograde cholangiopancreatography (ERCP) combined with endoscopic sphincterotomy (EST) on choledocholithiasis.Methods A total of 100 patients with choledocholithiasis were selected and randomly divided into observation group and control group in our hospital from February 2015 to February 2018.Patients in the control group were treated with laparoscopic cholecystectomy(LC) combined with choledochoscopy，while patients in the observation group received ERCP combined with EST.The stone removal rate，perioperative indexes，blood biochemical indexes before and after treatment and postoperative complications were compared between the two groups.Results The stone removal rate of the observation group was 98.00%，the control group was 100.00%

and there was no significant difference between two groups(P>0.05).The operation time，postoperative bedridden time and jaundice regression time in the observation group were shorter than those in the control group，and the intraoperative blood loss was less than that in the control group

the differences were significant(P<0.05).There was no significant difference in the contents of ALT，TBIL，ALB and TP between the two groups before treatment(P>0.05).After treatment，the levels of serum ALT and TBIL in the observation group were lower than those in the control group，while the levels of ALB and TP were higher than those in the control group

the difference was significant(P<0.05).There were 11 cases of complications which included cholangitis，pancreatitis，hyperamylase and stone recurrence in the observation group，while there were 12 cases in the control group.There was no significant difference in the incidence of complications between the two groups (P>0.05).Conclusion ERCP combined with EST has the advantages of faster recovery，the serum indexes improved obviously，and higher safety and efficacy.