The Relationship Between Juxtapapillary Duodenal Diverticulum And Pancreaticobiliary Diseases And The Effect Of Juxtapapillary Duodenal Diverticulum On The Diagnosis And Treatment Of ERCP

Objective:To explore the relationship between juxtapapillary duodenal diverticulum(JPDD)and pancreaticobiliary diseases and the effect of JPDD on the diagnosis and treatment of ERCP.Methods:The clinical data of 1230 patients who had received ERCP in general surgery departments of Shengjing Hospital of China Medical University from January 2012 to January 2017 were analyzed retrospectively.360 of them were found to have JPDD.41 of the patients with JPDD had intradiverticular papilla(IDP).The patients were divided into JPDD group and non-JPDD group according to whether a diverticulum was found.Then patients with JPDD were divided into IDP group and non-IDP group according to whether the papillary was located in diverticulum.The data of each group such as the incidence of pancreaticobiliary diseases,the success rate of cannulation and the stones removal,as well as the incidence of postoperative complications were statistically analyzed and compared.Results:The incidence of choledocholithiasis,primary choledocholithiasis and recurrent choledocholithiasis in JPDD group were significantly higher than those in non-JPDD group(P<0.05);No significant differences were observed in the success rate of cannulation and complete stones removal during the first ERCP session,as well as the incidence of postoperative complications between the two groups(P>0.05).The incidence of choledocholithiasis and primary choledocholithiasis in IDP group were higher than those in non-IDP group,but the differences were not statistically significant(P>0.05);The incidence of recurrent choledocholithiasis in IDP group was significantly higher than that in non-IDP group(P<0.05);There were no differences between the two groups in the success rate of cannulation and complete stones removal during the first ERCP session,as well as the incidence of postoperative complications(P>0.05).Conclusion:JPDD was associated with the occurrence and recurrence of primary choledocholithiasis,which seemed more related to IDP.JPDD should not be considered as an obstacle to the success of ERCP and the objective cause of postoperative complications.