Mechanical lithotripsy through the intact papilla of vater

The indications for endoscopic papillotomy are clearly defined. When only the normal risk presents, our working group favours an age limit of 50 years, below which the papilla should, as far as possible, be preserved. In the present case report, a possibility is described for effecting an endoscopic extraction of bile duct concrements through a completely intact papilla. It is thus apparent that, in certain cases, mechanical lithotripsy can also be employed to smash ductal stones through the intact papilla.