Influence of periampullary diverticulum on the occurrence of pancreaticobiliary diseases and outcomes of endoscopic retrograde cholangiopancreatography

Chen, Lu; Xia, Lu; Lü, Yi; Bie, Like; Gong, Bo

doi:10.1097/meg.0000000000000744

Cited by 39 publications

(57 citation statements)

References 32 publications

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“…Interestingly, that increased risk of adverse events appeared mitigated when needle-knife fistulotomy was used. In another large case-control study conducted in 1489 patients with PAD, the cannulation rates were similar to those without PAD (98.59 vs. 99.07%, P = 0.225) [17]. Likewise, complication rates were also similar among groups.…”

mentioning

confidence: 64%

“…Large stone removal can be difficult in the setting of PAD, when the altered anatomy and concern for perforation may limit the sphincterotomy length. The literature also supports a reduced rate of successful stone removal in patients with PAD with endoscopic sphincterotomy alone [17]. It is reasonable to estimate that this may have contributed to the less successful ERCPs in earlier studies, when balloon sphincteroplasty, endoscopic hydraulic lithotripsy, and other techniques for stone extraction may not have been as widely available.…”

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confidence: 92%

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ERCP Success Rate and Periampullary Diverticula: The Pocket Makes No Difference

Ketwaroo

Qureshi

2019

Dig Dis Sci

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confidence: 64%

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confidence: 92%

ERCP Success Rate and Periampullary Diverticula: The Pocket Makes No Difference

Ketwaroo

Qureshi

2019

Dig Dis Sci

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“…Many authors consider duodenal diverticula to be a risk factor for choledocholithiasis and relapsing lithiasis [4,8,9,11,14,18,21,25,29,40,42]. Lithiasis tended to occur more frequently among patients with duodenal diverticula than in patients with the major duodenum in normal location.…”

Section: Discussionmentioning

confidence: 99%

“…Although DD are usually asymptomatic and discovered incidentally in patients during ERCP, duodenal diverticula can be associated with various pathological conditions such as common bile duct obstruction, pancreatitis, perforation, bleeding, and in rare cases, carcinoma [1,2,3,8,27,30].…”

Section: Introductionmentioning

confidence: 99%

The position of a duodenal diverticulum in the area of the major duodenal papilla and its potential clinical implications

et al. 2021

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Background: Although duodenal diverticula are associated with less frequent pathology than the colonic diverticula in the large intestine, their periampullary position may have significant clinical implications. The aim of the study was to identify any possible correlation between the type of localization of the major duodenal papilla, duodenal diverticula, and some particular clinical issues. Materials and methods: In total, 628 patients (408 females and 220 males; aged 21-91 years), who underwent ERCP (endoscopic retrograde cholangiopancreatography) were included in this study. The patients were divided into two groups: a study group comprising 66 patients (10.5%) with periampullary position of diverticula (Group A), and a control group comprising 562 patients (89.5%) without diverticula (Group B). Results: A duodenal diverticulum was diagnosed in the periampullary position in 66/628 (10.5%) patients: 41 women (aged 52-91 years) and 25 men (aged 54-83). Conclusions: Three types of localization were observed for the major duodenal papilla with regard to the diverticula, with the most common type being next to each other (Type III). In patients with diverticula, similar frequencies of gallstone occurrence are observed in men and women. Patients with papilla in the diverticulum who underwent cholecystectomy are more prone to develop lithiasis.

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“…The ERCP procedure's success rate was defined according to the achievement of the preprocedural goal [13]. Adverse events included post-ERCP pancreatitis, perforations, cholangitis, and post-procedural bleeding evidenced by a drop-in hemoglobin >2g/dl.…”

Section: Data Typementioning

confidence: 99%

Impact of Periampullary Diverticulum on Biliary Cannulation and ERCP Outcomes: A Single-Center Prospective Study

Tabak¹,

Ji²,

Ma³

2020

Preprint

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Aim: This study aimed to investigate the association between periampullary diverticulum (PAD) and difficult biliary cannulation, as well as to evaluate the impact of different types of PAD on the cannulation success rate and adverse events. Methods: A total of 636 patients who underwent endoscopic retrograde cholangiopancreatography (ERCP) during the study period were prospectively studied and divided into two groups based on the presence or absence of PAD. In group A, 126 patients had PAD compared with 510 patients in group B without PAD. The primary outcome measurements were ERCP procedures time, selective cannulation techniques, and cannulation difficulty in addition to cannulation success rate and ERCP-related adverse events. The difficult cannulation was analyzed using logistic regression considering age, co-morbidities, the presence of PAD types, and indications as independent factors. Results: The average cohort age was 65.30±16.67 years, and 52.7% were male. Significant higher rates of choledocholithiasis, cholangitis, and biliary pancreatitis were reported in the group of PAD (p<0.05). Successful selective cannulation was achieved in 97.6% in group A and 95.3% in group B (p>0.05). The cannulation time was significantly longer in the presence of PAD (5.1 min, vs. 4.09 min, p<0.05). There was no significant difference in the rate of overall adverse events and post ERCP pancreatic PEP. Conclusion: The presence of PAD did not affect the duration or success of the ERCP procedure. Furthermore, it was associated with longer cannulation time and increase in the cannulation difficulty, especially with PAD type 1.

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Influence of periampullary diverticulum on the occurrence of pancreaticobiliary diseases and outcomes of endoscopic retrograde cholangiopancreatography

Abstract: PAD is associated with bile duct stones, gallstones, and cholangitis. In addition, PAD should not be considered a barrier to a successful cannulation. Moreover, EST is less effective than EPBD and ESBD in patients with PAD, whereas EST, EPBD, and ESBD are equally safe in patients with PAD.

Cited by 39 publications

References 32 publications

ERCP Success Rate and Periampullary Diverticula: The Pocket Makes No Difference

ERCP Success Rate and Periampullary Diverticula: The Pocket Makes No Difference

The position of a duodenal diverticulum in the area of the major duodenal papilla and its potential clinical implications

Impact of Periampullary Diverticulum on Biliary Cannulation and ERCP Outcomes: A Single-Center Prospective Study

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