Bile ducts lithiasis is a very common disease all over the world. In Italy prevalence is about 5 millions cases: 11% of the population. Choledocolithiasis concurrent with gallbladder stones frequency is estimated from 4 to 20%. Incidence is even higher in the elderly and in patients affected by chronic liver disease. The treatment of bile ducts lithiasis is still debated; several surgical strategies may be performed: 1) fully laparoscopic procedure; 2) endo-laparoscopic sequential treatment; 3) sequential inverse treatment (endoscopy following videolaparocholecystectomy); 4) combined endo-laparoscopic treatment simultaneously performed; 5) “open” treatment. The authors refer their experience concerning a series of 172 patients who underwent endo-laparoscopic sequential treatment to emend bile duct and gallbladder lithiasis. Complications are pointed out, pending to demonstrate safeness and effectiveness of this strategy.