Choledocolithiasis is present in about 10% of patients with cholelithiasis. Nowadays it is a common practice to perform an endoscopic retrograde cholangiopancreatography (ERCP) and laparoscopic cholecystectomy, but this means to open the papilla permanently. There is a new technique to treat this pathology; a transcystic laser lithotripsy without opening the common bile duct. In 2009 was published an article in surgical innovation by Dr. Day and colleagues, describing the technique. Since 2015 only few articles have been published using this method as a single procedure to treat cholelithiasis and choledocolithiasis, with series from 5 to 89 patients with very good results. This is a case of an 81 y.o. foreign woman with severe cardiac disease, polycythemia Vera, endarteritis and operated on a subtotal gastrectomy for gastric cancer 5 years ago with a Billroth II reconstruction. She went to a small hospital complaining of fever and abdominal pain. Total bilirubin 4,7 mg/dl with very increased alkaline phosphatase. An abdominal ultrasound reaveled cholelythiasis without enlargement of the biliary tract. Magnetic resonance cholangiogram revealed dilatation of the bile duct with a stone of 10,5 mm in the intrapancreatic choledoco. An ERCP was tried but was not successful because of the B-II gastrectomy. She was transferred to our central hospital for surgical treatment. We performed a laparoscopic cholecystectomy with transcystic exploration of the common bile duct with laser lithotripsy with a 3mm choledocoscope and an Holmium laser. The fragments were removed through the cystic duct. The procedure is exposed and explained in the video.