Objective To investigate the improved approach and bile duct approach of laparoscopic biliary tract exploration for the treatment of the elderly patients with common bile duct stones. Methods Ninety-two elderly patients with common bile duct stones were enrolled and randomly divided into the improved group and the conventional group ,with 46 cases in each group. The time of hemorrhage ,the time of common bile duct suture,the recovery time of gastrointestinal function,the time of hospitalization,body temperature,albumin and total bilirubin levels,complications and recurrence of stones were recorded and compared between the two groups. Results The time of hemorrhage,the time of common bile duct suture,the recovery time of gastrointestinal func-tion and the time of hospitalization in the improved group were lower than those in the conventional group(P<0.05, respectively). The body temperature of patients in the improved group was lower than that in the conventional group on 3 days after surgery(P<0.05). The overall incidence of postoperative complications in the improved group was lower than that in the conventional group (P < 0.05). No recurrence of stones was observed in both two groups. Conclusion The improved approach for laparoscopic common bile duct exploration surgery results in less bleed-ing,short common bile duct suture time,rapid postoperative recovery,less body temperature fluctuations and less complications,deserving popularization.