Résumé : 412 consecutive endoscopic sphincterotomies (E.S.) for common bile duct lithiasis have been reviewed in order to evaluate yield and complication rate of this technique in 3 clinical conditions. Acute biliary pancreatitis (A.P. n = 35), cholangitis (A.C. n = 121), both circumstances where E.S. was performed in emergency, and non urgent condition, including jaundice without septic complications (N.U. n = 256). For P.A., A.C. and N.U., E.S. was successfully achieved respectively in 97 %, 94 % and 96 %. Improvement of clinical condition was observed in 94 %, 89 % and 94 % either by adequate drainage or by complete clearance of stone (s). However, the rate of complete healing by endoscopic management alone was significantly lower in A.C. (72 %) when compared to P.A. (83 %) and N.U. (86 %). The overall figure for complication rate is 8.3 % and A.C. seems to be at risk patients from this group, versus 9 % in A.P. and 6 % in N.U. (p < 0.05). Overall mortality was 51394 achieved E.S., 4 deaths were observed in A.C. group. Modalities for improvement of the technique in this high risk group are discussed. © 1986 Springer-Verlag.