Introduction
The management of common bile duct (CBD) stones is well established. An algorithm showing the available strategies for the management of CBD stones following a routine or selective per-operative cholangiogram or a pre-operative endoscopic retrograde cholangiopancreatogram is illustrated in figure 1[1]. Although the laparoscopic exploration for CBD stones has gained grounds over endoscopic retrograde cholangiography ( ERCP) and sphincterotomy and duct clearance, there is no consensus as to the ideal approach [2, 3]. The management strategy chosen will depend on personal experience, equipment availability, time and the availability of other departmental expertise [3]. For a distally impacted CBD stone in a low resource setting, an open approach will entail either leaving the stone where it is and carry out a choledochoduodenostomy, or removing the stone through a transduodenal sphincteroplasty [4]. We present herein a hepaticoduodenostomy performed for an impacted distal CBD stone. This retained and impacted stone had complicated an open cholecystectomy for acute cholecystitis by causing biliary leakage from the dehisced ligated cystic duct stump due to back pressure of bile. We present the following case in accordance with the CARE reporting checklist.