Objective To investigate the feasibility and safety of laparoscopic combined with choledochoscopy for choledocholithotomy and primary suture. Methods 82 patients who underwent laparoscopic combined with choledochoscopy for choledocholithotomy and primary suture from Hechi People's Hospital from June 2016 to August 2018 were enrolled as study objects. They were divided into study group and control group according to the different treatment methods of common bile duct incision. 40 patients in the study group underwent primary suture of the common bile duct and 42 patients in the control group underwent T-tube drainage. The surgical outcomes and complications of the 2 groups were compared. Results All the patients in the two groups were operated smoothly and there were no cases of conversion to open surgery. The operation time, intraoperative blood loss, postoperative ambulation time, time of removal of abdominal drainage tube, and hospitalization time were lower in the study group than those in the control group, but the difference was not statistically significant (P>0.05). The incidence of electrolyte disturbance, postoperative recovery time, and hospitalization cost in the study group were lower than those in the control group, and the difference was statistically significant (P<0.05). The incidence of surgical complications in the study group was lower than that in the control group, but the difference was not statistically significant (P>0.05). Conclusion Laparoscopic combined with choledochoscopy for choledocholithotomy and primary suture in the treatment of intrahepatic and extrahepatic bile duct stones has good curative effect, rapid recovery, less internal environment disorder and low hospitalization cost. It is safe and feasible.