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A woman in her 80s was referred to gastroenterology as an outpatient for a scheduled endoscopic retrograde cholangiopancreatography (ERCP). Five months earlier, the patient had been admitted to the intensive care unit for biliary sepsis secondary to choledocholithiasis. She had an emergency percutaneous transhepatic cholangiogram (PTC) to allow for prompt biliary drainage. Subsequently, an ERCP was performed. A sphincterotomy and sphincteroplasty were performed; however, a large 15 mm stone could not be removed; therefore, a pigtail stent was inserted. After this, the patient clinically improved, and she was planned for a repeat ERCP in due course and was safely discharged with conservative management for her disease.