To investigate the effects of postoperative administration of Modified Wusi Decoction on postoperative recovery, complications, Traditional Chinese Medicine (TCM) syndromes, and clinical efficacy in patients with choledocholithiasis following laparoscopic common bile duct exploration with primary suture.

A prospective randomized controlled trial was conducted. A total of 98 patients diagnosed with choledocholithiasis who underwent surgical treatment at our hospital from January 2019 to December 2024 were continuously enrolled and randomly divided into the observation group (n=49) and the control group (n=49) using a random number table. The control group received routine postoperative care, including anti-infection, liver protection, and symptomatic supportive therapy. The observation group received self-made Modified Wusi Decoction in addition to the routine care, starting after the recovery of anal exhaust. The decoction was administered at 125 mL per dose, twice daily, for two consecutive weeks. Perioperative indicators, postoperative complications, TCM symptom scores, postoperative functional recovery, and overall clinical efficacy were compared between the two groups.

The time to first ambulation was significantly shorter and intraoperative blood loss was significantly lower in the observation group than in the control group (P<0.05). The total incidence of postoperative complications in the observation group (6.12%) was significantly lower than that in the control group (16.33%), with no cases of residual stones in the observation group (P<0.05). Scores for TCM symptoms such as postoperative abdominal pain, bloating, and loss of appetite were all significantly lower in the observation group (P<0.05). The observation group showed greater improvement in liver function indicators (Total Bilirubin (TBIL), Direct Bilirubin (DBIL), Alanine Aminotransferase (ALT), Aspartate Aminotransferase (AST)), shorter time to intestinal function recovery and first postoperative feeding, and significantly lower 24-hour postoperative pain scores and analgesic consumption compared to the control group (P<0.05). The total clinical effective rate was 100.00% in the observation group, significantly higher than the 83.67% in the control group (P<0.05).

The application of Modified Wusi Decoction following laparoscopic common bile duct exploration with primary suture can effectively promote postoperative recovery, reduce the incidence of complications, significantly improve TCM syndromes and liver function, alleviate postoperative pain, and enhance overall clinical efficacy. It represents a safe and effective therapeutic strategy integrating Chinese and Western medicine.