This case is about the management of a patient with complex choledocholithiasis. Given the widespread use of bariatric surgery, we are experiencing more and more patients with choledocholithiasis and altered gastrointestinal anatomy. This patient had an extensive surgical history and more importantly, she has had a duodenal switch. She presented with symptomatic choledocholithiasis. Given her bariatric surgery anatomy, standard ERCP procedures was not possible. Therefore, this video describes our approach to a laparoscopic transjejunal ERCP.