PURPOSE: ERCP (Endoscopic retrograde cholangiopancreatigraphy) and ES (endoscopic sphicterotomy) have become the main treatments for common bile duct (CBD) stone. However, when ERCP with ES fails to remove CBD stone, an operation is needed for stone removal. The aim of this study was to investigate the outcomes of laparoscopic CBD exploration (LCBDE) for the management of difficult choledocholothoasis. METHODS: This study was a retrospective analysis of 106 LCBDE cases that were performed from March 2001 to December, 2009. RESULTS: Of the 106 patients who underwent laparoscopic procedures, 74 were combined with gallstone and 105 underwent the choledochotomy approach. The mean operation time and mean hospital stay were 146.9+/-74.5 minutes and 11.0+/-6.4 days, respectively. The open conversion and stone clearance rates were 3.8% (4 cases) and 96% (102/106 cases). There were 10 complications with 3 cases of bile leakage, 2 cases of pulmonary complications, 4 cases of remnant stone and 1 case of subhepatic seroma. CONCLUSION: The LCBDE is a safe and feasible procedure. If ERCP is difficult or stone retrieval is incomplete, then LCBDE could be an alternative treatment for difficult CBD stone.