It is not uncommon to find large stones obstructing the bile duct in patients with recurrent pyogenic cholangitis. In a series of 291 patients with cholangitis, 32 patients had stones more than 2 cm in diameter. Endoscopic extraction using a combination of large baskets, 1% EDTA flushing, and manual or mechanical lithotripsy allowed the common bile duct to be cleared in 50% of patients. Lack of space in the common bile duct to open the retrieval basket because of stone impaction was the major reason for failure.