Woman, 55 yo, Cholecystectomy two years ago to treat lithias | Figure 1

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Case Details

Woman, 55 yo, Cholecystectomy two years ago to treat lithiasis, came with bilirubin levels 2.1, direct 1.8, phosphatase alkaline 450, gamma glutamyl transferase 500, came referred to ERCP. Cholangiography showed no signs of lithiasis and this tortuous biliary duct. Opinions?