A 39-year-old female patient presented to the upper gastrointestinal outpatient clinic with a protracted history of recurrent right upper quadrant pain. She was otherwise fit and well, with a body mass index of 30 and no previous operations. On physical examination, she was not clinically jaundiced and had abdominal tenderness in the right upper quadrant region on palpation. Liver function tests revealed a cholestatic picture with a bilirubin of 44 µmol/L (0–20 µmol/L), alanine aminotransferase of 613 U/L (10–35 U/L) and alkaline phosphatase of 281 U/L (30–130 U/L). Radiological imaging, including ultrasound and magnetic resonance cholangiopancreatography (MRCP), confirmed a fusiform dilatation of the common bile duct (CBD), left hepatic duct and first-order branch intrahepatic ducts, along with the presence of three calculi within the CBD, largest measuring 20 mm. Her management involved laparoscopic cholecystectomy, choledochotomy …