Fatty acid calcium stones in patients with pancreaticobiliary maljunction/choledochal cyst as another cause of obstructive symptoms besides protein plugs

Symptoms of choledochal cysts are caused by protein plugs, which clog up in the long common channel and increase pancreaticobiliary ductal pressure. We report that fatty calcium acid stones/debris are another previously unreported cause of obstructive symptoms in 2 cases with choledochal cyst.