We evaluated the usefulness of endoscopic papillary dilation (EPD) for treatment of patients with choledocholithiasis. Bleeding tendency, Vater's papilla in duodenal diverticulum, and poor general condition were risk factor of treatment with endoscopic sphincterotomy in 4 patients. A function of Vater's papilla had to be preserved in a young patient.
Therefore, EPD was performed and all of 5 patients were successfully treated without serious complications. The maximal size of stones treated with EPD was 10 mm in diameter. Atrophy and fibrous changes were observed histologically in the musclar layer of Vater's papilla, but its fundamental structure was conserved in a patient died from normal pressure hydrocephalus 2 months after EPD. We considered that EPD was a safe and usefull therapy for choledocholithiasis.
