Objective: To evaluate the clinical efficacy of laparoscopic cholecystectomy (LC) combined with laparoscopic common bile duct exploration (LCBDE) in the treatment of gallbladder stones with common bile duct stones. Methods: A total of 118 patients with gallbladder stones and common bile duct stones admitted to Nanyang Yuxi Jianhe Hospital from August 2022 to September 2024 were selected as research subjects, and were divided into control group and observation group by random number table method, with 59 cases in each group. The control group was treated with LC and endoscopic retrograde cholangiopancreatography (ERCP), while the observation group was treated with LC and LCBDE. The perioperative indicators (intraoperative time, length of hospital stay, medical expense) were compared between the two groups. The stone clearance rate was evaluated at 7 days after surgery, and the stone recurrence was followed up at 1 year after surgery. The liver function indicators [total bilirubin (TBIL), direct bilirubin (DBIL), alanine aminotransferase (ALT)] of patients before surgery and at discharge were detected in the two groups. The incidence rates of various postoperative complications were counted in the two groups. Results: Compared with control group, the intraoperative time and length of hospital stay in observation group were shorter, and the medical expense was lower, and the stone clearance rate at 7 days after surgery was higher while the stone recurrence rate at 1 year after surgery was lower, and the levels of TBIL, DBIL and ALT were lower at discharge, with statistical differences (P<0.05). There was no significant difference in the incidence of overall complications between the two groups (P>0.05). However, the incidence rates of pancreatitis, biliary stricture and reflux cholangitis in observation group were lower than those in control group (P<0.05). Conclusion: LC combined with LCBDE in the treatment of gallbladder stones with common bile duct stones can effectively clear the stones, promote the recovery of liver function, and reduce the risk of long-term recurrence and partial key complications.