OBJECTIVES: Endoscopic and laparoscopic surgeries are now widely used to treat patients with stones in gallbladder and common bile duct (CBD). The objectives of this study were to compare the economic and clinical results between two methods in the treatment of stones in gallbladder and CBD. METHODS: A computer model was established to assess the cost-benefit of two types of treatment from the provider's perspective. Treatment A provided two-stage procedure, which performs endoscopic sphincterotomy (EST) first and then followed by laparoscopic cholecystectomy (LC) (EST+LC). Treatment B is a one-stage procedure that performs laparoscopic surgery alone to remove both the gallbladder and stones in common bile duct (LCBDE+LC). Sources of parameters for the simulation model came from the results of published articles and patients received endoscopic and/or laparoscopic surgery in a medical center. RESULTS: Treatment B had a better successful rate than that of treatment A and a shorter length of hospital stay. However, treatment A had better stone removal rate. Under current insurance payment schedule, the net benefit of treatment A is NT$ 16,816 and NT$ -11,603 for treatment B. Therefore, it will be cost-beneficial to do EST+LC under current payment schedule. Sensitivity analysis showed that hospitals must reduce the cost of LCBDE+LC to NT$ 44,500 to avoid loss (currently NT$ 85,513). If the cost of LCBDE+LC can be reduced to 33,000, it can achieve the same benefit as EST+LC. CONCLUSIONS: Providers should hold the therapy of EST+LC to be the major treatment under current insurance payment schedule. LCBDE+LC is not commonly performed in Taiwan because of insufficient payment. However, it has the advantage of reducing patients' suffering, shorter operation waiting time, and shorter hospital stay. It would be beneficial to patients if hospitals can reduce the cost of LCBDE+LC and perform the procedure when appropriate.