J Korean Med Sci.  2012 Jul;27(7):772-776. 10.3346/jkms.2012.27.7.772.

Juxtapapillary Duodenal Diverticula Risk Development and Recurrence of Biliary Stone

• Ko KS
• Kim SH
• Kim HC
• Kim IH
• Lee SO

• KMID: 2157922
• DOI: http://doi.org/10.3346/jkms.2012.27.7.772

Abstract

We assessed whether the presence of juxtapapillary duodenal diverticula (JPDD) risks biliary stone disease and recurrence. In total, 695 patients who underwent ERCP were divided into two groups: biliary stone disease (group I, n = 523) and non-stone biliary diseases (group II, n = 172). Additionally, for a control group (group III), 80 age-matched healthy subjects underwent side-view duodenoscopy. In group I, rates of post-ERCP pancreatitis, cannulation failure, and disease recurrence in two-year follow up were compared according to the presence of JPDD. In results, the incidence of JPDD in group I (42.4%) was significantly higher than in group II (16.3%) and III (18.8%). The frequencies of JPDD were increased with age in all groups, and reached statistical significance in group I. In group I, rates of post-ERCP pancreatitis were significantly higher in patients with JPDD (18.5%) compared to JPDD negative (12.6%). The cannulation failure rate was also higher in patients with JPDD (9.9%) compared to JPDD negative (5.3%). Recurrence rate was higher in patients with JPDD (25.3%) compared to JPDD negative (9.2%). In conclusion, JPDD develops with aging and risks biliary stone formation. JPDD also seems to be associated with post-ERCP pancreatitis, cannulation failure and biliary stone recurrence.

Keyword

Biliary Stone; Juxtapapillary Duodenal Diverticula; Recurrence

MeSH Terms

Adult
Age Factors
Aged
Cholangiopancreatography, Endoscopic Retrograde/adverse effects
Cholelithiasis/complications/diagnosis/epidemiology
Diverticulum/*diagnosis/epidemiology/etiology
Duodenal Diseases/*diagnosis/epidemiology/etiology
Duodenoscopy
Female
Follow-Up Studies
Gallstones/complications/*diagnosis
Humans
Incidence
Male
Middle Aged
Pancreatitis/etiology
Recurrence
Risk Factors
Sphincterotomy, Endoscopic

Figure

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  Fig. 1 Juxtapapillary duodenal diverticula (JPDD) subtype classified by proximity to the major duodenal papilla. (A) Type 1 JPDD with the major duodenal papilla located within the diverticulum. (B) Type 2 JPDD with the major duodenal papilla located at the diverticular margin. (C) Type 3 JPDD with the major duodenal papilla adjacent to the diverticular margin.

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