Endoscopic sphincterotomy can replace operation. It was to be chosen in case of recurrence common bile duct calculi. The authors describe 11 complicated cases (2.01%) (9 women, 2 men) which demanded surgical management out of the 546 endoscopic sphincterotomy performed during 10 years (1982-1991). Operations were performed on 6 patients and 3 of them died (0.55%). Operation was necessary because of perforation and bleeding (2 perforations, 2 bleedings, 2 bleedings and perforations at the same time).