Background: Choledocholithiasis is a common and potentially serious complication of gallstone disease, often causing biliary obstruction, cholangitis, pancreatitis, and sepsis. Although endoscopic management is the preferred treatment, common bile duct exploration (choledocholithotomy) remains essential in cases of failed endoscopic clearance, large or impacted stones, altered anatomy, and complex biliary disease. However, postoperative complications remain a significant concern.

Objective: To assess the incidence and pattern of postoperative complications following common bile duct exploration for choledocholithiasis and to identify associated risk factors in adult patients at a tertiary care centre.

Methods: This prospective observational study was conducted in the Department of Surgery, Assam Medical College and Hospital, from 27th September 2024 to 26th September 2025. Sixty adult patients diagnosed with choledocholithiasis and undergoing common bile duct exploration were included. Data regarding demographic profile, clinical presentation, laboratory and imaging findings, operative details, postoperative complications, and hospital stay were collected and analyzed statistically.

Results: Most patients were middle-aged, with a female predominance, and abdominal pain was the most common presenting symptom. Choledocholithotomy with T-tube drainage was the most frequently performed procedure. The common postoperative complications observed were wound infection, bile leak, and cholangitis. Complication rates were higher in patients with preoperative cholangitis, jaundice, and comorbidities such as diabetes and hypertension.

Conclusion: Common bile duct exploration remains a safe and effective treatment for choledocholithiasis, especially in complicated cases. Careful patient selection, meticulous surgical technique, and appropriate perioperative management are essential to reduce postoperative morbidity and improve outcomes.

KEYWORDS: Choledocholithiasis, Choledocholithotomy, Common Bile Duct Exploration, Postoperative Complications, T-tube Drainage, Cholangitis.