Objective To investigate the effect of primary closure of LCBD on stress response, gastrointestinal function and complications after laparoscopic choledocholithotomy in patients with choledocholithiasis.Methods A retrospective analysis was made of 70 patients with choledocholithiasis underwent laparoscopic choledocholithotomy from June 2017 to June 2019. According to the different suture methods of common bile duct, they were divided into group A (primary closure of CBD after choledocholithotomy) 39 cases and group B (T-catheter drainage after choledocholithotomy) 31 cases. The indexes of serum stress reaction, gastrointestinal function recovery and the incidence of complications were compared between the two groups.Results The levels of adrenaline (A), cortisol (COR) and adrenocorticotropic hormone (ACTH) in the two groups were statistically significant compared with each other in group, time and interaction (P < 0.05). Compared with preoperative (T₁), the levels of A, COR and ACTH in the two groups were significant higher at 3 d after operation (T₂) (P < 0.05), and the levels of A, COR and ACTH in the B group at 1 week after operation (T₃) were significant higher (P < 0.05) . Compared with T₂ moment, the levels of A, COR and ACTH in the two groups were significant lower at T₃ (P < 0.05). The levels of A, COR and ACTH in group A were significant lower than those in group B at T₂ and T₃ (P < 0.05). The time to first flatus and time to first defecation after operation in group A was significantly shorter than that in group B (P < 0.05). The incidence of postoperative complications in group A was 5.13%, which was significantly lower than that of 25.81% in group B (P < 0.05).Conclusion Primary suture after laparoscopic choledocholithotomy can reduce postoperative stress response, improve gastrointestinal function and reduce the incidence of postoperative complications in patients with choledocholithiasis.