Endoscopic papillotomy has become a competitive method to the surgical technique. Endoscopy took over many cases formerly treated surgically. The indications to either procedure are defined. The alterations of papilla and peripapillary region of choledochus are treated by endoscopy. The surgical method is indicated in gallbladder diseases, in further accessory operations and in failing of endoscopic proceeding. The complication rate of endoscopic papillotomy is 6.7 p.c. and about 20 p.c. under the rate of the surgical method. The relation of mortality rate is given with 1.5 p.c.: 3.8 p.c. in favour of endoscopy. Indications, advantages, disadvantages and complications of both methods are discussed, using the own case material of 211 surgical and 714 endoscopic papillotomies.

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