Objective：To investigate the feasibility and indications of primary closure of the common bile duct (CBD) after choledochal exploration.
Methods：From January 2006 to January 2009, 149 patients with CBD stone(s) received primary closure of the common bile duct (group A) and were compared with 356 patients  with CBD stone(s) who received T-tube drainage (group B) after choledochal exploration. Intraoperative choledochoscopy was performed routinely to rule out the possibility of retained stones. The CBD was meticulously stitched using 5-0 monocryl absorbent sutures for primary closure. Following primary closure of the CBD, a drainage tube  was placed in the subhepatic space.
Results：Postoperative bile leakage was observed in 2 patients in group A and 13 in group B respectively (P＞0.05), but no reoperations were necessary. After surgery, the average volume of transfusion, normal eating time and postoperative hospital stay was 5.2 liters, 2.2 days and 7.2 days, respectively, in group A, versus 11.1 liters, 6 days and 16.7 days, respectively, in group B (P＜0.05). At 1-3 years follow-up，5 patients were found to have biliary stricture in group B, but none in group A.
Conclusions：Primary closure of the CBD after choledochal exploration in selected patients with common bile duct calculi is safe, effective and inexpensive, and could be regarded as an alternative procedure.