Multiple yellow-tan faceted gallstones are seen in the opened gallbladder pictured here following cholecystectomy in a patient who presented with colicky right upper quadrant pain for the past week. It is possible for a stone to exit the gallbladder via the cystic duct. It may then produce obstruction of the cystic duct, or it may get into the common bile duct (choledocholithiasis) and obstruct the common duct. It may obstruct at the ampulla of Vater and produce a pancreatitis. Biliary tract obstruction leads to jaundice with increased total bilirubin (predominantly direct bilirubin) in the serum.

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