However, laparoscopic surgery combined with cholangioscopy is still challenging due to various causes including: difficult manipulation of the cholangioscope due to increasing gap between the common bile duct and the abdominal wall when the abdomen is inflated, difficulty in maintaining the water pressure to dilate the bile ducts due to continuous water leak at the site of the bile duct opening, spillage of stone fragments and bile into the abdominal cavity leading to the need of continous suctioning, prolonged operative time and potential 2 residual abscess formation.