This is a 17-year-old African-American female who presented to ABCD General Hospital on 08/20/2003 with complaints of intractable right upper quadrant abdominal pain.  She had been asked to follow up and scheduled for surgery previously.  Her pain had now been intractable associated with anorexia.  She was noted on physical examination to be afebrile; however, she was having severe right upper quadrant pain with examination as well as a Murphy's sign and voluntary guarding with examination.  Her transaminases were markedly elevated.  She also developed pancreatitis secondary to gallstones.  Her common bile duct was dilated to 1 cm with no evidence of wall thickening, but evidence of cholelithiasis.  She was seen by the gastroenterologist and underwent a sphincterotomy with balloon extraction of gallstones secondary to choledocholithiasis.  Following this, she was scheduled for operative laparoscopic cholecystectomy.  Her parents were explained the risks, benefits, and complications of the procedure.  She gave us informed consent to proceed with surgery.