Of 65 patients with residual bile duct stones, 17 patients had a supraduodenal choledochotomy as the only operative procedure. Of the remaining 48 patients, a supplementary sphincteroplasty was carried out in 36 and a choledochoduodenostomy was added in 12 patients. Early postoperative results showed 2 deaths, while 40 patients passed an uneventful postoperative course. Following sphincteroplasty 3 patients had residual stones at the postoperative cholangiography. These calculi had disappeared at follow-up examination. Follow-up examination with a mean observation period of 6 yr revealed 50 patients free of symptoms. Four patients were reoperated on because of residual stones. None of these had a sphincteroplasty. In the operative treatment of residual bile duct stones sphincteroplasty and choledochoduodenostomy offer valuable supplements to supraduodenal choledochotomy.