[The significance of papillary biopsy in obstruction of Vater's papilla]

Biopsies of the papilla of Vater were taken in 53 patients after a papillotomy had been carried out during a previous ERC. The macroscopic finding of a papillary stenosis of unknown dignity required an exact histological diagnosis. In 35 patients (66%) a duodenitis/papillitis was found on the histological specimens, in 6 patients (11%) a villous adenoma, and in 7 patients an adenocarcinoma (13%). A metastasis of a melanoma, a schwannoma, and a coagulum were diagnosed once. The papillotomy preceding the biopsy was the only necessary therapy in 46 patients, and endoprosthesis was inserted in 5 patients. In 2 patients the tumor was excised by snare, in 4 patients a surgical resection was carried out. The incidence of malignancy in papillary stenosis emphasizes the significance of a biopsy for histological confirmation of the diagnosis if endoscopically a papillary stenosis is detected.