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A 68-year-old lady had presented 4 years previously with obstructive jaundice secondary to choledocholithiasis. Her only relevant history was a cholecystectomy in 1974. After sphincterotomy and mechanical lithotripsy, a balloon pull-through had cleared her common bile duct (fig 1). Despite this, recurrent choledocholithiasis and ascending cholangitis was necessitating endoscopic retrograde cholangiopancreatography (ERCP) every 3–4 months. Haematological and radiological investigation failed to reveal a cause for the recurrent stones and it was decided …
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