Six men have been jailed after smuggling "truly colossal" quantities of drugs from Holland to the UK in fake ambulances.
Cocaine, heroin and ecstasy were all involved, Birmingham Crown Court heard.
The drugs were sealed behind riveted panels inside a fleet of Dutch ambulances entering UK ferry ports with bogus patients and paramedics on board.
Police believe at least 45 trips, involving drugs with an estimated street value of £1.6bn, took place.
The sentencing hearing came after three Dutch nationals were jailed for their part in the same operation last year.
National Crime Agency officers tracked one of the ambulances on 16 June 2015, after it entered the UK via Harwich Port and went to a car park in Smethwick, Birmingham.
Vogelaar and Engelsbel got out of the ambulance wearing paramedic uniforms and met with Schoon and Bijlsma who arrived in a Mercedes car - all four men were arrested.
They were with a bogus patient on crutches who was later seen by officers walking around without them.
Officers found 193 kilos of cocaine, 74 kilos of heroin, two kilos of MDMA crystal and 20,000 ecstasy tablets with a combined potential street value of over £38 million.
The drugs had been bound with different coloured tape which correlated to a list of 20 customers found inside the car.
- James Gibson, 56, from Cinder Lane, Ollerton, Nottinghamshire: 20 years for conspiracy to import and supply Class A drugs, and concealing criminal property
- Richard Clarke, 36, from Tots Gardens, Acton, near Sudbury in Suffolk: 11 years for conspiracy supply Class A drugs
- Raymond DeSilva, 60, from Cranbourne Road, Slough: 16 years for conspiracy to import Class A drugs
- Darren Owen, 48, from Balham Close, Rushden, Northamptonshire: 15 years for conspiracy to import and supply Class A drugs
- Petrit Kastrati, 42, from Oakwood Drive, Crystal Palace: 17 years and six months for conspiracy to import Class A drugs
- Jonathan Floyd, 47, from Whitethorn Avenue, Burnage, Manchester: 15 years for conspiracy to import and supply Class A drugs and driving while disqualified
CCTV showed that during some drug smuggling trips the men stayed at the Holiday Inn Express in Colchester, Essex.
An industrial unit in the Moorside Business Park, Colchester, was often used as a location to transfer the drugs from the ambulances.
Brent Lyon, operations manager at the National Crime Agency, which led the operation to catch the smugglers, said their jailing has "disrupted" organised crime groups in the UK.
"This was an audacious plot by organised criminals who were driven by profit and who went to extreme lengths to avoid law enforcement attention," he said.
Sentencing the men at Birmingham Crown Court, Judge Francis Laird said: "This was a highly sophisticated, meticulously planned and well-executed conspiracy involving the importation of Class A drugs on a truly colossal scale."