Spontaneous closure of choledochoduodenostomy: diagnosis by endoscopy and ERCP

Choledochoduodenostomy has been recommended for the management of benign lower common bile duct obstruction, but opinion on this is still divided. Two cases are presented of recurrent cholangitis following choledochoduodenostomy, in which endoscopy and ERCP demonstrated closure of the choledochoduodenal anastomosis, continuing lower biliary obstruction and retained stones or debris. Persistent of recurrent symptoms following this operation may be due to stoma closure without adequate biliary drainage, and in these circumstances endoscopy with ERCP is proving most useful and in difficult cases may be the investigation of choice.