Abstract: Objective To explore the nursing problems and the corresponding countermeasures of senile patients with primary closure of laparoscopic common bile duct exploration(LCBDE). Methods The clinical data of 92 senile patients with common bile duct stones undergoing LCBDE was retrospectively analyzed. Out of these patients, 35 cases received primary closure of the common bile duct and 57 patients were given T-tube drainage. The nursing problems of primary suture were analyzed. Results Postoperative T tube placement in elderly patients caused massive loss of bile, resulting in the unbalance of water, electrolyte and acid-base, and poor absorption of lipids and protein nutrients. T tubes were inconvenient to carry, it was easy to occur traction pain at the fixed T tubes, and pulmonary infection as well as venous thrombosis of lower limbs. The primary suture of common bile duct is relatively safe and has an accurate effect, and can cause less complications, but its indications should be focused and postoperative biliary leakage should be prevented. Conclusion The nursing intervention can achieve the goal of rapid recovery for patients with primary suture after laparoscopic choledocholithotomy.