A 39-years-old Saudi patient presented to SGH-Jeddah complaining of recurrent abdominal pain. He was transferred from another hospital at Riyadh . Medical tests detected the presence of large gallstone and increase of bilirubin in the blood . Liver function tests and magnetic resonance imaging showed nothing abnormal. Previous lab tests results were requested from the other hospital to ensure that bilirubin is elevated consistently .After elaborative preparation, Surgeons decided to perform cholecystectomy. Liver biopsy was also done .Surgery was performed by Consultant General Surgery and Endoscopy .After the operation, patient went to a hospital room where she spent 2 days before leaving the hospital .