This video presents a comprehensive approach to the management of common duct pathology. Routine intraoperative cholangiography is advocated, and a straight forward method of percutaneous cholangiographic access is demonstrated. A variety of methods of managing common duct stones in a truly minimally invasive manner, i.e., via cystic duct access, is presented. Methods reviewed include balloon-catheter manipulation, fluoroscopically guided basket extraction, and choledochoscopic evaluation and removal of stones. The technique of laparoscopic choledochotomy, ductal exploration, T-Tube placement, and suture closure of the choledochotomy are also presented.