Objective:To analyze the effects of laparoscopic cholecystectomy(LC)combined with laparoscopic transcystic bile duct exploration and stone removal(LTCBDE)on clinical efficacy and immune function in elderly patients with gallbladder stones(GS)complicated by secondary common bile duct stones(CBDS).Methods:72 elderly patients with GS complicated by CBDS were divided into experimental and control groups according to different treatment methods,with 36 patients in each.The control group under-went LC+common bile duct incision stone removal with T-tube drainage(LCHTD),while the experimental group underwent LC+LTCBDE.The clinical efficacy and the impact of these two surgical methods on patients'immune function and inflammatory indicators were compared between the two groups.Results:There was no statistically significant difference in the total effective rate of treatment between the two groups(P＞0.05).The experimental group showed lower operative time,blood loss,hospital stay,and medical expen-ses compared to the control group(P＜0.05).The immune function indicators(CD3+,CD4+,CD8+T cell percentages and CD4+/CD8+ratio)in both groups were lower 3 days after surgery compared to pre-surgery(P＜0.05),but the experimental group had higher immune function indicators compared to the control group(P＜0.05).The inflammatory indicators(TNF-α,IL-10,CRP levels)in both groups were higher 3 days after surgery compared to pre-surgery(P＜0.05),but the experimental group showed lower inflammato-ry indicators compared to the control group(P＜0.05).Conclusion:LC+LTCBDE is an effective treatment for elderly patients with GS complicated by CBDS,which can effectively shorten hospital stay,reduce medical expenses,mitigate surgical impact on patient im-mune function,and result in a lighter inflammatory response.