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JUXTAPAPILLARY DIVERTICULA AND ENDOSCOPIC TREATMENT OF BILE DUCT STONES
Author(s) -
Horaguchi Jun,
Fujita Naotaka,
Noda Yutaka,
Kobayashi Go,
Kimura Katsumi,
Ito Kei,
Takasawa Osamu
Publication year - 2005
Publication title -
digestive endoscopy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.5
H-Index - 56
eISSN - 1443-1661
pISSN - 0915-5635
DOI - 10.1111/j.1443-1661.2005.00551.x
Subject(s) - medicine , major duodenal papilla , bile duct , common bile duct , diverticulum (mollusc) , surgery , endoscopic treatment , gastroenterology , endoscopy
Aim: To assess the influence of juxtapapillary diverticula on endoscopic treatment of bile duct stones. Methods: Two hundred and fifty‐eight consecutive patients with bile duct stones who had undergone endoscopic treatment at our department were included in this study. Comparison was done between a group that had a juxtapapillary diverticulum (Group D) and a group that did not (Group N). Results: Deep cannulation was achieved in 98% and 100% of Group D and Group N, respectively. The time required for cannulation was 18 min in both groups. Deep cannulation of the bile duct tended to be difficult in cases with the papilla located at the edge of or in the diverticulum in Group D. Complete removal of stones was achieved in 97.7% and 96.9% of the respective groups. The number of sessions and the total time required for removal of stones in Group D and Group N were 1.6 and 47 min, and 1.5 and 47 min, respectively (n.s.). The occurrence rate of complications was not statistically different (12.4% vs 10.1%); however, it was higher (50%) in those who had a papilla inside the diverticulum. Conclusions: Although the presence of juxtapapillary diverticula has only a subtle influence on endoscopic treatment of bile duct stones, caution is necessary when treating patients with a papilla in a diverticulum because of the high incidence of complications in such patients.