A 56-year-old man was referred to our hospital with a complaint of repeated pancreatitis. US and ERCP revealed a choledochocele and multiple bile duct stones. Endoscopic sphincterotomy (EST) and removal of stones failed because a guide wire could not be inserted into the bile duct. Thus, choledocholithotomy and "rendezvous" endoscopic sphincterotomy were performed under laparotomy. The choledochocele disappeared and there was no biliary stricture in the intraoperative cholangiography. This present procedure is a useful modality.
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