The patient proceeded to surgery for open duodenectomy:
- midline laparotomy
- large palpable gallstone in D2/3
- kocherization of duodenum limited by cholecystoduodenal fistula superiorly
- longitudinal duodenotomy over large gallstone on anterolateral aspect of D2/3
- gallstone delivered, smaller gallstone more proximal also removed.
- closed with omental patch
The patient recovered well, nil complications.