Open CBD exploration surgery is becoming less common as more endoscopy treatments are developed. However, in cases where patients are unstable and cannot be treated with endoscopy, open CBDE surgery is an important option for the patients. In this video, we will demonstrate OC with CBDE surgery in patients with severe cholangitis who cannot be treated with endoscopy. Some surgical details and techniques, such as the location of the T-tube, were used for surgeon preference. We hope you enjoy this video.