Our purpose was to determine if the presence of duodenal diverticula predispo ses to the development of pancreaticobiliary disease. Between May 1999 and Febru ary 2001, 381 patients were examined by endoscopic retrogr...
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Our purpose was to determine if the presence of duodenal diverticula predispo ses to the development of pancreaticobiliary disease. Between May 1999 and Febru ary 2001, 381 patients were examined by endoscopic retrograde cholangiopancreati cography. Of these patients, 51 had periampullary diverticula. In 27 patients th e papilla was located inside the diverticulum (Group I), in 19 patients it was l ocated at the edge of the diverticulum (Group II), and 5 patients it was located at a distance closer than 3 cm to the diverticulum (Group III). Seventeen patie nts in group I and 11 patients in group II had had a previous cholecystectomy. T he overall incidence of biliary system stone disease was 22.2% in group I, 36. 8% in group II, and 100% in group III. All patients were treated with endosc opic sphincterotomy and three (two in group I and one in group II) developed bil iary system disease (cholangitis or pancreatitis). We think that sphincterotomy should be applied regardless of the presence of stone if the papilla is located inside or at the edge of the diverticulum. If the papilla is located 3 cm or mor e far for diverticulum , it should be considered within the frame of general sph incterotomy indications in the absence of stone disease.
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