It has not been firmly established whether dysfunction of the sphincter of Oddi, biliary dyskinesia, exists as a distinct clinical entity. Improved diagnostic methods, such as ERCP and different manometric studies combined with provocation tests, have provided objective evidence that, in some patients with what is termed the postcholecystectomy syndrome, a spastic sphincter of Oddi is a cause of their complaints. Controlled randomised clinical studies are lacking, but previous results have shown that either operative or endoscopic papillotomy might be indicated in some patients with sphincter Oddi dyskinesia.