Five cases of choledochoduodenal fistulas secondary to duodenal ulcer disease occurred. All patients had a surgical procedure for their duodenal ulcer disease, although the presence of a fistula in itself is not an indication for surgery. In three patients difficulty was encountered in closing the duodenal stump due to the presence of the fistula. A new procedure was utilized in two of these patients in which the opened duodenal stump was sutured to ulcer margins enclosing the fistula. Internal bile drainage was adequately maintained and duodenal stump blowout was avoided by this technique. No patient has had any evidence of postoperative ascending cholangitis.