Papillitis and the postcholecystectomy syndrome.

The importance of papillitis as a disease entity capable of producing significant symptoms is not well appreciated. Presenting symptoms are usually pain or cholestasis. The cholangiographic appearance of papillitis may mimic that of papillary tumor and small distal common bile duct stone; endoscopic papillotomy (EPT) with biopsy may help clarify the diagnosis. In patients with delayed drainage, EPT may be therapeutic. Two cases of papillitis that presented as difficult diagnostic and therapeutic problems are reported.