Association of Periampullary Diverticula with Primary Choledocholithiasis but not with Secondary Choledocholithiasis

Kim, M.-H.; Myung, Seung Jae; Seo, Dong-Woo; Lee, S. K.; Kim, Y. S.; Lee, M. H.; Yoo, Byung Moo; Min, Meng

doi:10.1055/s-2007-1001363

Cited by 51 publications

(39 citation statements)

References 8 publications

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“…Advanced age contributes to the development of PD due to weakening of regional connective tissue [9]. A prevalence of 5-32% has been reported in patients undergoing duodenoscopy, and prevalence increases with age and with female gender [1,4,10]. In a study on 350 patients, Zoepf et al reported a PD incidence of 12.5%, and higher average age of patients with PD compared to those without PD [3].…”

Section: Discussionmentioning

confidence: 99%

The impact of periampullary diverticula on the endoscopic treatment of choledocholithiasis

Aslan¹,

Arabul²,

Alper³

et al. 2012

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Section: Discussionmentioning

confidence: 99%

The impact of periampullary diverticula on the endoscopic treatment of choledocholithiasis

Aslan¹,

Arabul²,

Alper³

et al. 2012

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“…The variation is due to the different study methods used and the different ages of the subjects investigated. A recent barium study showed a prevalence of 6% [1], and in studies employing endoscopic retrograde cholangiopancreatography (ERCP), it varied between 4.1 and 31.7%, with most around 10–20% [2,3,4,5,6,7,8,9]. On the other hand, a rate of 19.4% has been reported at autopsy [10].…”

Section: Incidence Of Jpdmentioning

confidence: 99%

“…There seems to be no gender predilection. The vast majority of JPD are located on the oral side of the major papilla [9 ](fig. 1).…”

Section: Incidence Of Jpdmentioning

confidence: 99%

Juxtapapillary Duodenal Diverticula and Pancreatobiliary Disease

et al. 2010

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Juxtapapillary duodenal diverticula (JPD) are observed in around 10–20% of patients undergoing endoscopic retrograde cholangiopancreatography (ERCP). They are acquired extraluminal outpouchings of the duodenal wall through ‘locus minoris resistance’ and their incidence increases with age. They have been studied mainly with regard to their association with pancreatobiliary disease. Choledocholithiasis is considered to be strongly associated with JPD, but the role of JPD in the development of cholecystolithiasis and pancreatitis is still disputable. Since JPD are located in the vicinity of the papilla of Vater, they not only cause mechanical compression of the bile duct but also induce dysfunction of the sphincter of Oddi. They are considered to lead to bile stasis and to allow reflux from the duodenum into the bile duct, which results in an ascending infection of β-glucuronidase-producing bacteria. The ERCP procedure can be hampered by JPD, although recent papers have reported no difference in the successful cannulation rate or complications between patients with JPD and those without JPD. Disorders caused by JPD are amenable to appropriate therapy, e.g. endoscopic sphincterotomy and surgical intervention.

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“…8 Although a large majority of PAD are asymptomatic, association with various pancreaticobiliary complications is established in the current literature, including increased incidence of choledocolithiasis and pancreatitis. 9,10 This is generally thought to be a consequence of both mechanical compression of the distal CBD as well as dysfunction of the sphincter of Oddi. 9 Thus, radiologists are more permissive of dilated CBD in the presence of PAD when reporting.…”

Section: Introductionmentioning

confidence: 99%