Two cases of choledocholithiasis with a juxta-papillary diverticulum were reported. The first case was a 78-year-old female who had had a cholecystectomy one and a half year before. A black calculus was found in the common bile duct and cholangiography via the T-tube showed a 44 mm sized juxta-papillary duodenal diverticulum that was left as it was. The second case was a 41-year-old male whose ERCP examination revealed a stone shadow in the dilated common bile duct and a 20 mm sized juxta-papillary duodenal diverticulum. There were no inflammatory findings in the gallbladder, and no calculi or debris in it were found. A bilirubin calculus which was thought to be induced by the diverticulum existed in the common bile duct. Resection of the diverticulum was performed, but postoperative pancreatic fistula developed which demanded troublesome efforts of us. Finally the patient could recover.Since it is thought that juxta-papillary duodenal diverticula are predisposing factors for biliary calculi, surgical procedures suitable for choledocholitiasis with them should be selected with regard to postoperative complications and recurrence.
