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Chunlong Zhao,1,2,&ast; Zipeng Xu,1,&ast; Weidong Hu,1,&ast; Chen Ge,1 Zhengwei Zhang,1 Zhengxing Dai,3 Shuo Zhang,4 Neng Tang,4 Weiguo Wang,3 Jiayu Gu,3 Chaobo Chen,1,4,5 Songbing He2 1Department of General Surgery, Xishan People’s Hospital of Wuxi City, Wuxi, People’s Republic of China; 2Department of General Surgery, The First Affiliated Hospital of Soochow University, Suzhou, People’s Republic of China; 3Department of Interventional and Vascular Surgery, Xishan People’s Hospital of Wuxi City, Wuxi, People’s Republic of China; 4Department of Hepatic-Biliary-Pancreatic Surgery, the Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, People’s Republic of China; 5Department of Immunology, Ophthalmology & ORL, Complutense University School of Medicine, Madrid, Spain&ast;These authors contributed equally to this workCorrespondence: Chaobo Chen; Songbing He, Email bobo19820106@gmail.com; hesongbing1979@suda.edu.cnBackground: Laparoscopic cholecystectomy (LC) with laparoscopic common bile duct exploration (LCBDE) is convenient in treating cholelithiasis and choledocholithiasis due to its advantage of accelerated recovery. This retrospective study aimed to summarize the experience of cholelithiasis and choledocholithiasis treatment via three-port approach of LCBDE in Eastern China.Methods: Patients diagnosed with cholelithiasis and choledocholithiasis between July 2019 and October 2021 were included. Patients who received LC+LCBDE+primary suturing of the common bile duct (CBD) via a three-port approach were assigned to the LCBDE-P group, and those who received LC+LCBDE+T-tube drainage of CBD comprised the LCBDE-T group. The measurement data were compared between the two groups. P-values < 0.05 indicated statistical significance.Results: A total of 88 patients were divided into two groups: LCBDE-P (n=50) and LCBDE-T (n=38). Multiple logistic regression analysis showed that LCBDE-P is associated with a shorter length of stay (OR=0.115, 95% CI: 0.040– 0.329, P< 0.001) and lower hospitalization costs (OR=0.120, 95% CI: 0.041– 0.357, P< 0.001). No significant differences between the two groups were detected in the operation time, intraoperative hemorrhage, clearance rate of CBD stones, postoperative liver function, and postoperative complications (P> 0.05).Conclusion: The three-port approach of LCBDE is a safe and feasible strategy for managing cholelithiasis and choledocholithiasis. Compared to LCBDE-T, LCBDE-P reduces the length of hospital stay and medical costs during hospitalization.Keywords: cholelithiasis, choledocholithiasis, laparoscopic cholecystectomy, laparoscopic common bile duct exploration, primary suture, T-tube drainage