Presentation
Patient post liver transplantation, presenting with Jaundice and elevated liver enzymes.
Patient Data
The endoscope accesses a choledochoduodenostomy and shows a normal intrahepatic biliary system.
The endoscope's catheter has an inflated balloon at the level of the anastomosis to maintain the pressure in the biliary system and drive the contrast into the bile ducts, rather than draining into the duodenum.
Case Discussion
Choledochoduodenostomy connects a resected common bile duct to the duodenum via a choledochoduodenal "fistula" (a surgical anastomosis).
This can be useful in a number of settings, both benign and malignant, including choledocholithiasis, bile duct stricture, choledochal cysts, and some types of biliary obstruction.