Differences in Clinical Characteristics between Juxtapapillary Duodenal Diverticulum and Intradiverticular Papillae

Abstract

Purpose: To clarify the difference in clinical characteristics between juxtapapillary duodenal diverticulum (JPDD) and intradiverticular papillae (IDP) patients, we performed a clinical study comparing these 2 groups. Methords: Patients with duodenal diverticula located less than 2 cm from the papilla Vateri were divided into 2 groups [groups A (10 JPDD patients: 5 men and 5 women, 47 to 84 years of age; mean age: 67.3 years) and B (6 IDP patients; 4 men and 2 women, 52 to 89 years of age; mean age: 70.3 years)]. We retrospectively assessed differences in the clinical characteristics between groups A and B. Results: Clinical symptoms: Abdominal pain was detected in all patients in both groups. Fever and jaundice were more frequent in group B than A. Laboratory data (AST, ALT, AlP, LAP, γ GTP, amylase, bilirubin) on admission: Abnormal values were more common in group B than group A. The frequency of the elevation of the serum values, such as ALP, LAP, and γ GTP in group A was significantly lower than that in group B (p=0.010). Size of the diverticulum: Patients in group A had a smaller diverticulum than those in group B. Diameter of the common bile duct: Patients in group A had a narrower bile duct than those in group B. Sites of stones: Choledocholithiasis was more freReceived: October 23, 2015/ Accepted: March 7, 2016 Correspondence to: Ryouichi Tomita Department of Surgery, Nippon Dental University School of Life Dentistry, 2-3-16 Fujimi, Chiyoda-ku, Tokyo 102-8158, Japan quent in group B than group A. Kinds of stone: Calcium bilirubinate stones were more common in group B than group A. Bactobilia in the gallbladder was more frequent in group B than group A. Conclusions: Patients with IDP showed abnormal data in their clinical characteristics compared with those with JPDD. Especially, abnormal data on ALP, LAP and γ GTP were clearly found in patients with IDP compared with those with JPDD.