Plausible reasons that might be attributed to this correlation are extensive inflammation in the main bile duct by stones when they pass via the cystic duct, concurrent acute biliary pancreatitis and cholangitis, premature release of inflammatory cytokines such as serum interleukin-2, interleukin-6 and tumour necrosis factor-alpha and the fact that with no Oddi’s sphincter left to protect, bacterial migration to main bile duct is common leading to fibrosis of the hepatoduodenal ligament. The gene discussed is IL6; the disease is cholangitis.