Objective: To investigate the efficacy and safety of primary closure of the common bile duct plus nasobiliary drainage via antegrade transabdominal approach in treatment of common bile duct stones. Methods: One hundred and thirty-eight patients with gallstones and concomitant choledocholithiasis admitted in the Department of Hepatobiliary Surgery of Hunan Provincial People’s Hospital from August 2015 to February 2017 were enrolled. Of the patients, 45 cases underwent laparoscopic cholecystectomy, common bile duct exploration and endoscopic nasobiliary drainage with primary choledochal closure (nasobiliary drainage group), and 93 cases underwent laparoscopic cholecystectomy and common bile duct exploration plus T-tube drainage (T-tube drainage group). The main clinical variables between the two groups of patients were compared. Results: Operations were successfully completed in all the 138 patients, and no serious surgical complication occurred. In nasobiliary drainage group compared with T-tube drainage group, the operative time, intraoperative blood loss and volume of bile drainage on the first postoperative day showed no significant difference (all P>0.05), but the time to postoperative bowel function recovery, retention of the bile drainage tube, length of hospital stay and hospitalization cost as well as the amount of postoperative fluid infusion, and the volume of bile drainage on the second and third postoperative day were all significantly reduced (all P<0.05). There was no significant difference in overall incidence of postoperative complications between the two groups (P>0.05), but the incidence of symptoms of electrolyte imbalance such as nausea and vomiting in nasobiliary drainage group was significantly lower than that in the T-tube drainage group (P<0.05). Conclusion: Nasobiliary drainage extends the indications for primary closure of the common bile duct, and can shorten the tube retention time and length of hospital stay, and reduce the fluid and electrolyte disorders, with no increase of complications such as bile leakage and biliary stricture. It has certain superiority to T-tube drainage, but its indications should be followed.