Objective To study the clinical feasibility of primary suture in laparoscopic common bill duct exploration on the Tibetan plateau.Methods This is a retrospective analysis of patients who underwent primary closure of the CBD after laparoscopic choledochotomy between February 2015 and June 2018 in Tibet Autonomous Region Corps Hospital of Chinese People’s Armed Police Force. 48 cases were divided into control group and observation group according to the operative method. 25 cases in primary closure group as observation group and 23 cases in intraoperative indwelling T-tube drainage group as control group. Clinical effect was compared between the two groups.Results The duration of surgery and the postoperative hospital stay were shorter in the observation group than in the control group, and the difference was statistically significant(P<0.05). However, there was no statistically significant difference between the two groups in intraoperative blood loss, the incidence of bile leakage, duration of abdominal drainage or in the amount of ascites.Conclusions Primary suture used in laparoscopic common bill duct exploration is safe and feasible when an appropriate surgical approach is chosen on the Tibetan plateau.