A 45 years old female Egyptian patient from Fakus , Sharkia , Egypt was presented by upper abdominal pain and jaundice .Abdominal ultrasonography revealed dilated common bile duct (CBD). ERCP showed apparently healthy major duodenal papilla with mild swelling , X ray showed dilated CBD . Sphincterotomy was done with introduction of both basket and balloon in many attempts without extraction of stones. The patient pain and jaundice were relieved .2 months later the patient complained of pain and jaundice again. Another ERCP was performed and showed infiltration of the major papilla. 6.5 cm , 10 F plastic stent was introduced in the CBD with good drainage of bile ( video) . Microscopic examination of the biopsies revealed malignant cells. The patient was operated radically later on.