The article contains results of a continuous prospective investigation of the normal course of the major duodenal papilla stenosis in 167 patients. It was revealed that the course of the disease was benign, pain syndrome became inconsiderable in the course of time, the degree of changes in biochemical analysis of blood was not significant. The development of complications (choledocholithiasis, acute pancreatitis, jaundice) was noted in 6-14% of the patients, depending on the presence or absence of GID. The data obtained allow suggestion of an algorithm of managing the patients.