Abstract: Objective To explore the operation skills and clinical effects of continous suture and intermittent snture for laparoscopic common bile duct exploration with primary suture in the treatment of elderly patients with common bile duct stones. Methods The clinical data of 276 elderly patients with common bile duct stones treated by laparoscopic common bile duct exploration with primary suture in our center from January 2020 to January 2023 were retrospectively analyzed, including 181 cases of continuous suture with barb suture (continuous suture group) and 95 cases of intermittent suture with vicryl suture (intermittent suture group). The general data, perioperative related indexes and the incidence of postoperative complications were compared between the two groups. Results All laparoscopic surgery had been successfully completed, without any case of conversion. There were no statistical differences in general data, the diameter of common bile duct, the thickness of common bile duct wall and the diameter of stones between the two groups (P>0.05). The operation time, the time of bile duct suture and operation bleeding volume in continuous suture group were better than those in intermittent suture group (P<0.05 or P<0.01). Seven cases with bile leakage were recovered by continuous drainage, but the incidence rate of bile leakage in continuous suture group was less than that in intermittent suture group (1.1% vs 5.3%, P=0.037). After 3-24 months of follow-up, there were no significant differences in the residual rate of stone and recurrence rate of cholecystolithias between the two groups. Conclusions Compared with intermittent suture, laparoscopic common bile duct exploration with primary suture by continuous suture is an effective and safe minimally invasive surgery for the elderly patients with common bile duct stones, which can shorten the operation time, reduce the complications, and accelerate the postoperative recovery.

Key words: common bile duct stone, primary suture, continuous suture, intermittent suture, aged