Objective: To compare the effects between laparoscopic transcystic common bile duct exploration (LTCBDE) and laparoscopic common bile duct exploration (LCBDE) with primary biliary suture in treatment of common bile duct stones. Methods: The clinical data of 104 patients undergoing minimally invasive therapy for common bile duct stones from January 2013 to December 2015 were retrospectively analyzed. Of the patients, 50 cases received LTCBDE treatment (LTCBDE group) and 54 cases had LCBDE plus primary biliary suture (LCBDE plus primary suture group). The main clinical variable between the two groups were compared. Results: In LCBDE compared with LCBDE plus primary suture group, the operative time (91.7 min vs. 110.9 min), intraoperative blood loss (15.5 mL vs. 17.4 mL), amount of postoperative drainage (28.4 mL vs. 44.6 mL), tube retention time (7.8 d vs. 9.7 d) and length of hospital stay (8.8 d vs. 10.6 d) were all significantly reduced (all P<0.05). The incidence of postoperative bile leakage in LTCBDE group was significantly lower than that in LCBDE plus primary suture group (2.0% vs. 13.0%, P=0.036), while no significant difference was noted in incidence of other postoperative complications between the two groups (all P>0.05). Conclusion: In treatment of common bile duct stones, LCBDE is safe and reliable, and more accurately reflect the requirements of minimal invasiveness than LCBDE plus primary biliary suture. So it is recommended to be the first choice for the conditions with indications for both procedures.