Common bile duct stones are encountered in up to 20% of patients with gallstones. Endoscopic retrograde cholangiopancreatography (ERCP) has become the standard method of treatment for this problem, in conjunction with laparoscopic cholecystectomy, as two-stage management. However, for some patients ERCP may not be available or technically possible, such as after roux-en-y gastric bypass. Laparoscopic common bile duct exploration has been shown to have decreased hospital length of stay and cost over two-stage management. We demonstrate the management of common bile duct stones with laparoscopic cholecystectomy, intra-operative cholangiogram, transcystic choledochoscopy, and common bile duct exploration in a patient who has had a prior gastric bypass. This patient was admitted to an outside hospital with abdominal pain and found to have gallstones and elevation of her liver function tests. MRCP imaging revealed a common bile duct stone so she was transferred to our facility for care and her bile duct was cleared laparoscopically using this technique. We outline how transcystic common bile duct exploration can be performed with standard equipment that can be found in most operating rooms, as well as technical pearls for performing transcystic common bile duct exploration for the general surgeon.