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Sine 1976, 2380 eases of ERCP were performed at the Kwangju Chrietian Hospital. Nighty eight patients with periampullary choledochaduodenal fistula diagnosed at ERCP were revewed, Following result were obtained 1) Cases were most commonly noted from fifth decade to seventh decade, and sex distribution was similar. 2) Right upper quadrant abdominal was most common clinical manifestation, and duration of illness prior to diagnosis were from 2 months to 20 years. Several weeks or days before ERCP, sudden disappearance of pain suggeeted spontaneous extrustion of a stone from the common bile duct to the duodenum with resultant PACD formation. 3) On past history, various types biliay operations had carried out in 26 patients. Subtotal gastrectomy with gastrojejunostomy in 1 patients, operation for CBD ascaris removal in 1 patient. 4) Most PACDF had finding formed recently on ERCP and fibrosis, inflamation, granulation, atrophic change, adhesive stenosis were noted additionally. 5) Most common cause of PACD by ERCP was biliary teact stone. 6) Endoscopic sphincteropapillotomy(EST) were performed in 39 patients with PACDF due to CBD stone and surgical intervention were done in 36 patients due to CBD stone also. It was interesting that EST were performed in 3 patients with old stenotic fistula.
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