Introduction/ Laparoscopic cholecystectomy is the most common procedure performed for management of symptomatic gallstone disease. This, however, can be complicated by formation of fistulous communications between biliary tree and gastrointestinal tract. This abnormal communication allows flow of bile and bowel contents between two systems (biliary system and intestine) which can cause abdominal pain, nausea, vomiting, and biliary sepsis. We would like to present a rare case of fistulous communication between cystic duct stum and duodenum and outline possible contributing factors. Literature review describes the most common interventions for management of fistulas with emphasis on ERCP and stent preferences to eliminate transpapillary pressure gradient which directly contributes to fistula closure. Conclusion/ This case is particularly interesting as it combines several uncommon complications of gallstone disease. The patient had a parahepatic pus collection, which perhaps was the reason for abdominal discomfort, a cystic duct remnant – duodenal fistula, and an obstructing calculus in the distal CBD. This once again highlights the paramount importance of understanding biliary anatomy. The main reason for biliary fistulas is retained infected gallstones and ongoing inflammatory process leading to an increased transpapillary pressure. This case outlines the importance of biliary tree de-compression in management of biliary fistulas. ERCP is a safe and effective procedure for diagnosis and management of biliary fistulas. Preference should be given to the larger calibre of stents to alleviate the pressure.