Endoscopic biliary interventions through the choledochoduodenostomy

Introduction: Biliary cannulation is a well established procedure during ERCP. In case of failed cannulation we usually apply precutting on the papilla of Vater. Occasionally, we can reach the common bile duct from proximally, through a previously performed choledochoduodenostomy. Case: An 83-years-old female was admitted to our unit because of biliary pain and obstruction. The MRCP suggested suspition of common bile duct stones. Cholecystectomy was performed 40 years ago, followed by choledochoduodenostomy two years later in her history. The cannulation of the papilla was impossible because of hidden position o…