Periampullary Diverticulum May Be an Important Factor for the Occurrence and Recurrence of Bile Duct Stones

Abstract

There is a close correlation between PAD and the formation of biliary tract stones. A particularly close correlation was found between PAD and choledocholithiasis after cholecystectomy. PAD may be an important risk factor for the occurrence or recurrence of biliary tract stones.

Proton pump inhibitor is a risk factor for recurrence of common bile duct stones after endoscopic sphincterotomy – propensity score matching analysis

“…PD has been reported to be a risk factor for development of CBDS, while intra-diverticular overgrowth of bacteria and bile flow disturbance are also believed to increase its incidence 21 22. As noted in those studies, clinical presence of PD is thought to be a risk factor and the hazard ratio was 1.873 in the current COX proportional hazard model findings, thus we cannot deny that possibility.…”

Size and type of periampullary duodenal diverticula are associated with bile duct diameter and recurrence of bile duct stones

“…After the introduction of three types of PAD according to the position of the major papilla in endoscopic examination, these types have become generally accepted for the classification of PAD. In the aspect of size, large and small PAD were suggested by a diameter cut‐off of 15 or 20 mm …”

Biliary dilatation in the presence of a periampullary duodenal diverticulum

“…Previous studies have concluded that a diameter of either 1.5 or 2.0 cm should be used to classify small and large PAD. 2,6 PAD originates at weak areas in the duodenal wall, which include perivascular connective tissue sheath pathways and the entrances of the common bile duct (CBD) and pancreatic duct. 7 It has been previously shown that increasing age leads to increase in prevalence of PAD.…”