96 year-old female, 20 years previously underwent a cholecystectomy, patient was hospitalized with abdominal pain in the right upper quadrant, tenderness and jaundice, elevated alkaline phosphatase more than 800 units, the total billirubins more than 18, direct billirubin: 16.9. Physical examination showed generalized jaundice. Patient underwent an endoscopic Needle-knife precut sphincterotomy draining great amount of suppurative material successfully treated endoscopically and with course of two broad-spectrum antibiotics during four ten days. CBD stones are either primary or secondary. Primary stones arise within the biliary duct system, while secondary stones develop in the gallbladder and migrate to the CBD. Endoscopic biliary drainage is a safe and effective measure for the initial control of severe acute cholangitis due to choledocholithiasis and to reduce the mortality associated with the condition. Older age has been considered a risk factor for increased morbidity and mortality rates in the treatment of acute cholangitis.
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