Objective：To explore the plan of minimally invasive operation methods for managing the common bile duct stones (CBDS) according to different conditions.
Methods：The clinical data of 203 patients with CBDS treated in our department during last 9 years were analyzed retrospectively. According to the different type of operation, the patients were devided into: Endoscopic papillary balloon dilatation (EPBD) group, including 22 cases, endoscopic sphincterotomy  (EST) group, including 105 cases; and laparoscopic common bile duct exploration (LCBDE) group, including 76 cases.
Results：Statistically significant difference was not found among the three groups in success rate of surgery, recent complications rate or residual stone  rate (P＞0.05).The operation time was significantly different statistically (P=0.000), and the shortest was LCBDE group. Hospital stay was statistically significantly different (P=0.000), and the shortest was EPBD group. Stone recurrence, reflux cholangitis and papillary stricture rate were statistically different(P＜0.05), they were equivalent in LCBDE group and EPBD group, and worst in EST group.
Conclusions：EPBD should be carried out as the first choice for patients with CBDS. If EPBD fails or there is no indication for EPBD, LCBDE can be selected, while EST should be applied only to suitable candidates with strict indications.