Recurrent Biliary Calculi Duodenal Diverticula as a Predisposing Factor

Løtveit, T; Osnes, M; Larsen, Stig

doi:10.1097/00000658-198207000-00007

Cited by 42 publications

(16 citation statements)

References 10 publications

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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%

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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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Section: Incidence Of Jpdmentioning

confidence: 99%

“…In this study, biliary calculi indicated choledocholithiasis and cholecystolithiasis, collectively. When these two sites where stones exist are studied separately, most papers have accepted the fact that choledocholithiasis was primarily correlated with JPD [3,4,5,6] (fig. 2).…”

Section: Jpd and Biliary Tract Diseasementioning

confidence: 99%

Juxtapapillary Duodenal Diverticula and Pancreatobiliary Disease

et al. 2010

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“…The incidence of JPD increases with age23; this may induce bacterial contamination of bile in patients with an incompetent sphincter resulting in primary CBD stone formation 24. A JPD was present in 60% of our patients, probably due to their age (median age 66 years), but it was not a significant factor for recurrent CBD stones or delayed biliary emptying in this study.…”

Section: Discussionmentioning

confidence: 50%

Prediction of recurrent choledocholithiasis by quantitative cholescintigraphy in patients after endoscopic sphincterotomy

Lai

Peng

et al. 1997

Gut

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Background-Endoscopic sphincterotomy (EST) is widely used for the removal of stones from the bile duct, but stones recur in about one fifth of patients. Aims-To investigate hepatic clearance by quantitative cholescintigraphy (QC) in patients after EST and to discern the relationship between biliary emptying and stone recurrence. Methods-One hundred and forty nine patients who had EST and clearance of the bile duct for choledocholithiasis were selected. All patients were confirmed to have complete EST by sphincter of Oddi manometry and underwent QC soon after normalisation of liver function. Regular clinical follow up was performed for each patient. Results-During a mean 36 month follow up, 22 (14.8%) patients developed recurrent stones in the bile duct. Irrespective of the status of the gall bladder, patients with recurrent stones had a slower hepatic clearance of radioisotope during QC compared with patients without stone recurrence, but only the diVerences in cholecystectomised patients had statistical significance. After carrying out multivariate analysis, one parameter of QC, percentage clearance of maximal count at 45 minutes, was found to be the only significant factor for stone recurrence. All recurrent stones in the common bile duct were successfully removed at endoscopy. Conclusion-Slower hepatic clearance as shown by QC is an important factor responsible for stone recurrence after sphincter ablation.

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“…However, numerous factors associated with their origin appear to be of importance. With regard to the formation of concretions in the biliary duct, there are adequate findings concerning the effects of benign or malignant strictures, of bacterial infection and parasites, and of metabolic changes and dietary habits, as well as those of anatomical conditions in the bilioduodenal region [1][2][3][4][5][6]. However, there are only sporadic reports about for eign material as a cause of lithiasis [7][8][9].…”

Section: Introductionmentioning

confidence: 99%