A 75-year-old man in eastern China came to the emergency department with a month of on-and-off upper abdominal pain. His skin and the whites of his eyes were faintly yellow, and blood tests pointed to a blocked, infected bile duct. A CT scan showed stones in his common bile duct, along with two dense foreign objects that did not belong there.
Sixteen months earlier, surgeons had removed his gallbladder and cleared stones from his bile duct in a single laparoscopic operation, leaving a T-tube drain that was taken out six weeks later. When a team at Taicang Affiliated Hospital of Soochow University reopened the duct, they found both objects embedded in stones: a Hem-o-lok clip, a locking plastic clip, and a titanium clip. Both had originally been placed on the artery supplying the gallbladder.
