Impact of Periampullary Diverticula on
Bile Duct Stones and Ampullary Carcinoma
Necati Örmeci, Xheni Deda, Çağdaş Kalkan, Ali Emrehan Tüzün, Fatih Albayrak, Abdulkadir Dökmeci, D Kadir Bahar
Citation Information :
Örmeci N, Deda X, Kalkan Ç, Emrehan Tüzün A, Albayrak F, Dökmeci A, Kadir Bahar D. Impact of Periampullary Diverticula on Bile Duct Stones and Ampullary Carcinoma. Euroasian J Hepatogastroenterol 2016; 6 (1):31-34.
Introduction: Periampullary diverticula (PD) is caused by extraluminal pouching of duodenal mucosa.
Using a very common endoscopic procedure to diagnose or treat gastrointestinal disorders, we
encountered duodenal diverticulum.
Materials and methods: This is a retrospective, single-center study. Three thousand and sixteen
patients on whom endoscopic retrograde cholangiopancreatography (ERCP) was performed at Ankara
University Medical School, Department of Gastroenterology, from June 2009 to June 2014 were included
to the study.
Results: Hundred and thirty patients (males 65, females 65) among the 3,016 had PD. Two hundred and
sixty patients without diverticulum were randomly chosen from the 3,016 patients, as a control group
[121 (47%) females, 139 (53%) males]. There was no statistical difference between the two groups. The
mean age of the patients with PD was 69.9 years, while the mean age was 62.3 years for patients without
PD (p < 0.001). Incidence for PD was 4.6%. The papilla of Vater was located in the inter-diverticular
area (Type 1) in 9 patients (8.3%), at the edge of the diverticulum (Type 2) in 31 patients (28.4%), and
at a distance of 2 to 3 cm from the papilla (Type 3) in 69 patients (63.3%).
Discussion: Although numerically more common bile duct stones occurred in patients with PD compared
to those without PD, there was no statistical difference between the two groups. The rate of pancreatobiliary
carcinomas was higher in patients without diverticulum. Cannulation was successful in both
groups at the rate of 97.6 and 92% respectively, but cannulation failed more often in patients without
PD. Duodenal perforation occurred in one patient with PD. Bleeding after sphincterotomy occurred in
two patients without PD.
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