Objective: To compare the clinical efficacy of using unidirectional barbed suture (UBS) and traditional suture (TS) in primary closure of the common bile duct following laparoscopic common bile duct exploration (LCBDE).  
Methods: The clinical studies comparing using UBS and TS in LCBDE with primary choledochal closure published in English and Chinese were searched through online databases. The retrieval time was up to September 2018. After the quality evaluation and data extraction of the included studies, Meta-analysis was performed by using RevMan 5.1 and STATA 12.0 software.
Results: Ten studies were finally included with three randomized controlled trials (RCTs) and seven observational studies, involving a total of 848 patients. The results of overall analysis showed that the time for bile duct suturing (WMD=–11.38, 95% CI=–14.81––7.94, P<0.001), operative time (WMD=–20.55, 95% CI= –30.63––10.46, P<0.001) and length of hospital stay (WMD=–0.78, 95% CI=–1.47––0.09, P<0.05) were all shortened, and the incidence of bile leakage (RR=0.23, 95% CI=0.10–0.55, P<0.001) was decreased significantly in UBS group compared with TS group. The results of subgroup analyses based on study design showed that except the length of hospital stays had no statistical difference between the two groups (WMD=–0.06, 95% CI=–0.61–0.49, P=0.83), all the others were consistent with the results of overall analysis. 
Conclusion: UBS not only provides a new approach for laparoscopic primary choledochal closure, but also is feasible and safe. However, this conclusion still needs to be verified by more multicenter and well-designed randomized controlled trials.