Juxtapapillary duodenal diverticula risk development and recurrence of biliary stone.
We assessed whether the presence of juxtapapillary duodenal diverticula (JPDD) risks biliary stone disease and recurrence. In total, 695 patients who underwent ERCP were divided into two groups: biliary stone disease (group I, n = 523) and non-stone biliary diseases (group II, n = 172). Additionally, for a control group (group III), 80 age-matched healthy subjects underwent side-view duodenoscopy. In group I, rates of post-ERCP pancreatitis, cannulation failure, and disease recurrence in two-year follow up were compared according to the presence of JPDD. In results, the incidence of JPDD in group I (42.4%) was significantly higher than in group II (16.3%) and III (18.8%). The frequencies of JPDD were increased with age in all groups, and reached statistical significance in group I. In group I, rates of post-ERCP pancreatitis were significantly higher in patients with JPDD (18.5%) compared to JPDD negative (12.6%). The cannulation failure rate was also higher in patients with JPDD (9.9%) compared to JPDD negative (5.3%). Recurrence rate was higher in patients with JPDD (25.3%) compared to JPDD negative (9.2%). In conclusion, JPDD develops with aging and risks biliary stone formation. JPDD also seems to be associated with post-ERCP pancreatitis, cannulation failure and biliary stone recurrence.
Division of Gastroenterology and Hepatology, Department of Internal Medicine and Research Institute of Clinical Medicine, Chonbuk National University Medical School, Jeonju, Korea.
Kang Suk
KS
Ko
Seong Hun
SH
Kim
Hyun Chul
HC
Kim
In Hee
IH
Kim
Seung-Ok
SO
Lee
D000328:Adult; D000367:Age Factors; D000368:Aged; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000009:adverse effects; D002769:Cholelithiasis / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology; D004240:Diverticulum / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology; D004378:Duodenal Diseases / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology; D004384:Duodenoscopy; D005260:Female; D005500:Follow-Up Studies; D042882:Gallstones / Q000150:complications / Q000175:diagnosis*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000209:etiology; D012008:Recurrence; D012307:Risk Factors; D016717:Sphincterotomy, Endoscopic