Normal measurements of the circumference of the extrahepatic bile ducts were established. These measurements were not altered by peptic ulcer, gastric carcinoma or general peritonitis. There was dilatation of the extrahepatic ducts in the presence of disease of the gall bladder wall, roughly in proportion to the severity of disease. Distress after cholecystectomy is closely related to dilatation of the bile ducts after cholecystectomy, both being due to loss of the absorptive function of the gall bladder and rise in pressure within the duct system. In one case of severe distress after cholecystectomy the circular fibers of the choledochal sphincter showed marked hypertrophy.