[Sump syndrome. Treatment by endoscopic biliary "rendez-vous" procedure]

Sump syndrome consists on an entity in which the distal portion of the biliary tree does not drainage by the major papilla, so food and bile are retained and infections could appear leading to cholangitis. The real incidence of the sump syndrome after side-to-side choledocoduodenostomy is unknown, but has been described less than 10%. Several procedures have been used to solve it but at present endoscopic sphincterotomy is of choice the treatment of this condition that is followed by a good outcome. When major papilla can not be negotiated, an endoscopic approach consisting in a biliary endoscopic <> procedure could be used, negotiating the biliary tree by the side-to-side choledocoduodenostomy in this case. We report a clinical case of a patient with a side-to-side choledocoduodenostomy because of choledocolithiasis who developed a sump syndome. He was treated by a biliary endoscopic <> procedure because a papillary stenosis did not allow a transpapillar access to the biliary tree.