The chronic grade II pancreatitis is not depicted here. Thus a soft terumo guide wire is advanced via the fistula into the bile duct and reaches the duodenum in a retrograde way. The wire is extracted orally with a loop and used to insert a papillotoma for performance of a papillotomy. Thereafter both ducts drain properly in an antegrade way. The patient is free of complaints and has gained considerable weight.
Diarrhea has ceased, enzyme substitution is no longer necessary.
See also duodenal fistula .