Pérez Moyano, SaraArranz Solana, CésarGuilarte López-Mañas, Julio2023-05-032023-05-0320221130-0108http://hdl.handle.net/10668/21708An 87-year-old female was admitted for endoscopic retrograde cholangiopancreatography (ERCP) due to obstructive jaundice. On admission, total bilirubin was 15 mg/dl at the expense of direct bilirubin, GOT 356 U/l mg/dl, GPT 174 U/l, FA 2,358 U/l and GGT 1,089 U/l. The ERCP showed a prominent, irregular, non-cannulable papilla, so a fistulotomy was performed, emitting a clear, non-mucous fluid. Biliary localization was verified after inserting the guidewire. Cholangiography showed dilatation of the intra-extra hepatic bile duct (common bile duct 18-20 mm). An uncoated metal prosthesis was implanted and a biopsy was performed, confirming papillary adenocarcinoma.enAged, 80 and overBileBile Duct DiseasesBilirubinCholangiopancreatography, Endoscopic RetrogradeFemaleHepatic Duct, CommonHumansJaundice, Obstructiveresearch article34315214open access10.17235/reed.2021.8098/2021https://doi.org/10.17235/reed.2021.8098/2021