Endoscopic biopsies of the papilla of Vater at the time of endoscopic sphincterotomy: difficulties in interpretation.

The hypertrophic aspect of tissue after endoscopic papillotomy may suggest the diagnosis of a small periampullary tumor. In our experience of 55 periampullary carcinomas, the diagnosis was confirmed histologically in 50% of the cases before endoscopic papillotomy and in 100% of the cases when the biopsies were performed immediately after papillotomy. With this in mind, biopsies were performed in 22 cases of benign biliary tract disease after endoscopic papillotomy. Biopsies within the first 48 hours after endoscopic papillotomy showed cellular atypism.