We apply laparoscopic transcystic duct stone removal (LTR), as well as laparoscopic cholecystectomy (LC) as one of therapies for cholecystocholedocholithiasis. In performing LTR, we employ the intercostal approach for the choledochus with good outcomes. The procedures are as follows: the gallbladder is disssected from the liver bed and suspended with an endo-loop at the neck. Catheter introducer (CI) is penetrated from the mid clavicular line on the right 6th or 7th intercostal space and inserted into the choledochus through the cystic duct. These procedures enable an easy access and maneuver of choledochoscope via CI. Although the choledocholith is generally removed with the basket forceps, we also apply the transcystic ductal papillary dilatation or an explosion of the stone with pulseddye laser, which depends on clinical case. We applied LTR via this approach to 22 cases out of a total of 1700 cases received LC in our hospital. Removal of stones was successfully performed in all 22 cases without severe complications, and the patients could be discharged after shorter hospital stay. Combination of LTR with LC was least likely to spoil the efficary of LC and the papillary function was preserved. The LTR via intercostal approach is thus advantageous for safe and easy exploration of the common bile duct.