Objective: To investigate the difference in efficacy between primary closure and T-tube drainage following laparoscopic cholecystectomy (LC) with laparoscopic common bile duct exploration (LCBDE) in treatment of gallbladder stones combined with common bile duct stones. 
Methods: The clinical data of 218 patients undergoing LC+LCBDE from April 2013 to April 2018 were retrospectively analyzed. Of the patients, 90 cases underwent primary closure of the common bile duct and 128 cases were subjected to T-tube drainage. The main clinical variables between the two groups of patients were compared, and the factors for the occurrence of complications were analyzed.
Results: There were no significant differences in preoperative general data, intraoperative blood loss, time to first postoperative anal gas passage, incidence of postoperative electrolyte disturbance and residual stone rate between the two groups (all P>0.05). In primary closure group, the operative time, length of postoperative hospital stay and hospitalization cost were reduced, but the time for postoperative abdominal drainage was prolonged significantly compared with T-tube drainage group (all P<0.05). In primary closure group versus T-tube drainage group, the incidence of postoperative bile leakage was significantly higher (8.89% vs. 2.34%, P=0.030), while the incidence of postoperative stone recurrence rate was significantly lower (1.11% vs. 7.03%, P=0.040). Statistical analysis showed that primary closure was an independent risk factor for the occurrence of postoperative bile leakage, and T-tube drainage was an independent risk factor for the occurrence of stone recurrence (both P<0.05).
Conclusion: In LC+LCBDE, primary closure can effectively reduce the recurrence of postoperative common bile duct stones, while T-tube drainage can effectively reduce the incidence of postoperative bile leakage. These two methods cannot entirely be replaced by each other, and the indications should be rigorously followed.