Abstract Detachment of the papilla of Vater from the duodenum may happen (a) deliberately, during duodenal resection for tumour without concomitant resection of the pancreatic head, and (b) accidentally in the course of gastrectomy for duodenal ulcer, when attempts to exteriorize the ulcer are made. In this report two case histories are cited encompassing both of these circumstances, in which the ampulla was successfully reimplanted into a Roux loop.