This 38 year old lady had developed obstructive jaundice a few months after undergoing cholecystectomy. The ultrasound report indicated a single stone in the distal CBD. Her cholangiogram outlined a single large stone seen as a negative shadow just above the scope (A: white arrow). The surgical clips from her cholecystectomy were also visible (A: green arrow). We did a papillotomy and we're doing a routine check of adequacy of the papillotomy by withdrawing a fully open sphincterotome. That apparently was enough to pull the stone out (B: white arrow shows the stone and the sphincterotome in the duodenal lumen). We did a routine sweep of the CBD with an extraction balloon, followed by an occlusion cholangiogram with contrast injection over a fully inflated balloon in the distal CBD (C: white arrow shows the inflated balloon) which showed no negative shadows.
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