Purpose: Choledocholithiasis occurs in approximately 10–15% of patients undergoing cholecystectomy. This study evaluates the feasibility, safety, and effectiveness of a newly implemented laparoscopic transcystic bile duct exploration (TCBDE) service in a hospital without daily access to endoscopic retrograde cholangiopancreatography (ERCP). Methods: A TCBDE service was established in February 2024, supported by a dedicated bile duct exploration trolley, single-use fibreoptic choledochoscopes, and structured in-service training for surgical and nursing staff. Prospective data was collected from February 1, 2024, to January 24, 2026. Outcomes assessed included procedural success, complications, length of stay (LOS), and ERCP-related bed days saved. Retrospective data from November 1, 2024, to October 31, 2025, was analysed to determine the total number of laparoscopic cholecystectomies (LCs) performed and the proportion of patients requiring pre- or post-LC ERCP for choledocholithiasis. Results: Thirty laparoscopic TCBDEs were performed, with a success rate of 90% (27/30). Twenty procedures utilised choledochoscopy with nitinol basket extraction, while ten were performed using a Nathanson basket under image intensification. Intraoperative cholangiography identified incidental common bile duct stones in 23 cases. Three complications occurred: one bile leak requiring ERCP, one bile leak requiring return to theatre for washout, and one case of post-procedure pancreatitis. Over a 12-month period, 712 LCs were performed. 70 patients (9.8%) required pre- or post-LC ERCP. Choledocholithiasis was identified preoperatively in 43 patients (6.0%) and intraoperatively in 27 patients (3.8%). 32 patients (4.5%) underwent LC and ERCP during the same admission, with a mean LOS of 8.3 days, compared with 2.3 days for patients undergoing TCBDE. Conclusion: TCBDE is a valuable skill for general surgeons, particularly in centres with limited ERCP access. Its use can reduce treatment delays, shorten hospital stay, and improve cost-effectiveness.