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A patient has upper abdominal pain and gallstones. Surgery relieves her of at least some of the latter but not the former. She has a variety of postcholecystectomy syndrome, a condition afflicting 5%, more or less, of the 750 000 patients undergoing primary biliary operations yearly in this country. Principal causes of the syndrome, among those related to the biliary tract, are retained stones and stenosing papillitis. But is the pain of biliary tract origin? That question may be difficult to answer. The possible answers are here knowledgeably considered, with an expert's approach to finding and treating the right one.