The ultrasound report said this lady had gallstones and a 1.5 cm calculus in the distal CBD. The story inside was different. The ampulla didn't look like a bus had gone through it. The CBD had no negative shadows signifying stones either(A) . We did a papillotomy followed by sweeping the CBD with extraction balloon. This was followed by an occlusion cholangiogram (B) showing a clear CBD. An unexpected incident was the breaking of the guidewire sheath and being lodged in the right system (B:red arrow). It couldn't be retrieved. Maybe the surgeon will get it when she goes for a cholecystectomy.
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