Endoscopic Retrograd Cholangiopancreatography for Choledocolithiasis in Patients With Periampullary Diverticulum

Mete Akın, Erhan Alkan, Yasar Tuna, Gokhan Aksakal, Cem Kockar, Altug Senol


Aim: Periampullarydiverticulum (PAD) is usually discovered incidentally during endoscopicretrograde cholangiopancreatography (ERCP). It may be a cause of difficultcannulation and can be related with morbidity, according to the size of diverticulumand position of papilla.  Papilla may belocalised intradiverticular or extradiverticular. In this study, we evaluatedcomplications and success of ERCP in patients  with choledocolithiasis and PAD. Materials and Methods:40 patients whom performed ERCP with the diagnosis of choledocolithiasisand discovered PAD during the procedure were included the study. 40 patientswithout PAD were selected as control group.Both groups were compared in terms of complications, success ofcannulation, need for precut sphincterotomy, stent placement and surgery,beacuse of residual stones. Findings were compared in terms of same parametersin diverticulum group according to position of papilla.  Results: Therewere 21 men and 19 women in PAD group (mean age 72,9 ± 9,9  years) and 20 men and 20 women in controlgroup (mean age 68,1 ± 12 years) (p > 0,05). Papilla vater located extradiverticularin 22 patients and intradiverticular in 18 patients. Bleeding and/orperforation associated with ERCP was not observed, in both groups. There werenot significant differences between the groups in terms of success ofcannulation, need for precut sphincterotomy, stent placement, surgery andpost-ERCP pancreatitis (p > 0,05). There were not significant differences interms of same parameters in diverticulum group according to position of papilla(p > 0,05).  Conclusion: PADisn’t associated with an increased risk for complications and not affect thesuccess of  ERCP.


Endoscopic retrograd cholangiopancreatography; complication; periampullary diverticulum

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