86-year-old woman who underwent cholecystectomy and ERCP for choledocholithiasis performing sphincterotomy and stone extraction. She presented to our center for epigastric pain without infection signs, finding common bile duct (CBD) dilatation and choledocholithiasis in MR-cholangiopancreatography. ERCP was performed, finding dilatation of common bile duct (15-17mm) and a 12-15mm stone with radiopaque content like surgical clips, being unable to define if it was in CBD or cystic duct. After failed attempt of standard stone extraction, an endoscopic papillary large-balloon dilatation was performed and stone removed with balloon catheter. Stone was recovered and analysed, confirming the presence of a surgical clip inside.
