You have a patient with multiple tiny gall stones. She had a couple of biliary colics and her LFT is normal. USG report is multiple gall stones and sludge in the GB, with normal CBD diameter. You have done a simple lap chole and sent her home. On third or fourth day she calls you to inform that she has pain in abdomen, quite a serious one and has vomited twice. You advise her antiemetics and pantoprazole and reassure her that pain will go in a few days. But she calls you back again next day.
Reluctantly you get her admitted. She is not clinically jaundiced, has a soft abdomen and while on IV fluid seems deceptively normal. But LFT shows high bilirubin, SGOT,SGPT and Alkalline Phosphatase. MRCP is ordered; there is sludge in the lower end of CBD. Next day ERCP is done, sludge evacuated and a stent is placed. This story is known to you all. Though innocuous, but it leaves the surgeon…
