title: Symptomatic choledochoceles in adults. Endoscopic retrograde cholangiopancreatography recognition and management.
abstract: During a 2-year interval, we identified 10 patients with symptoms of pancreaticobiliary disorders and small choledochoceles by endoscopic retrograde cholangiopancreatography. Patients ranged from 36 to 89 years of age. Eight were female. Seven presented with recurrent, acute pancreatitis, two presented with biliary colic, and one presented with cholangitis. Dilated common bile ducts were seen in four patients, and no other biliary lesions were demonstrated in any patients. Five patients were shown to have normal gallbladders by ultrasonographic or computed tomographic criteria. Choledochoceles were identified endoscopically as a bulge above or involving the ampulla. Diagnosis was confirmed by cholangiography. All patients underwent successful unroofing of the choledochocele and sphincterotomy of the common bile duct. One pancreatic sphincterotomy was performed for pancreatic ductal obstruction. We encountered no complications. Hospital stays ranged from 1 to 4 days. Follow-up intervals ranged from 2 to 20 months. At this time, no patients have had any recurrence of symptoms, and none has required rehospitalization or surgery.
authors.affiliation: Department of Surgery, Maine Medical Center, Portland 04102.
authors.forename: R F
authors.initials: RF
authors.lastname: Martin
authors.forename: B P
authors.initials: BP
authors.lastname: Biber
authors.forename: J J
authors.initials: JJ
authors.lastname: Bosco
authors.forename: D A
authors.initials: DA
authors.lastname: Howell
mesh_terms: D000328:Adult; D000368:Aged; D000681:Amylases / Q000097:blood; D002758:Cholangiography; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000379:methods / Q000592:standards*; D015529:Choledochal Cyst / Q000145:classification / Q000175:diagnosis / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008049:Lipase / Q000097:blood; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D016717:Sphincterotomy, Endoscopic / Q000379:methods / Q000592:standards*
chemical_list: D008049:Lipase; D000681:Amylases