Clinical Research Of ERCP For Juxtapapillary Duodrnal Diverticula Combined Weth Choledocholithiasis

Aim:To analyse and summarize internal connection between duodenal papilla, juxtapapillary duodenal diverticula and endoscopic retrograde cholangiopancreatography (ERCP) treatment for periampullary diverticula combined with choledo-cholithiasis. Hope to provide clinical support.Methods:Data of 110 choledocholithiasis patients underwent ERCP, from March 2013 to December 2015 in our hospital, were collected and retro-spectively analyzed, of which,110 cases were combined with duodenal papilla diverticulua. Divide them into three groups based on the location that papilla was outside, in or on the edge of JPD, the cases are respectively 55,7 and 48. Make a comparison about age, bile stone, ERCP, EST, EPBD, removing stone successfully rate and complications.Results:There were 88 cases of single diverticulum, accounting for 80.0%. 107 patients successfully underwent catheterization, the success rate was 97.3%. Stones were successfully removed in 88 patients and the success rate was 80.0%.1. The age distribution concentrate in the 60 years of age or older, the proportion of the group outside the diverticulum was highest at the age of 70 to 79.The proportion of the group on diverticulum’edge was highest at the age of 60 to 69 years old.2. Three groups had no statistical difference of gallstones’number and largest diameter, P>0.05.3. When not using assisted catheterization, the success rate of the group outside the diverticulum (83.6%) was lower than the group on diverticulum’ edge (97.9%). When using assisted catheterizations (8 cases), the success rate of group outside the diverticulum rose to 98.2%, having no statistical differences with the other two groups, P=0.261.4. There was no statistical difference of EST or EPBD’s distribution, P= 0.753. Each group’s EST+EPBD had the highest utilization rate and highest success rate. About EST+EPBD, the success rate of group at the edge of the diverticulum (100%) was higher than the group in the diverticulum (60%), P= 0.022.5. Among the postoperative complications, high blood amylase was the most commonly occurs (16.4%), but three diverticulum groups had was no statistical difference (P> 0.05)..Conclusions:1. Single diverticulum’quantity was the most.2. The age distribution concentrate in 60 years of age or older. The population of group outside the diverticulum most concentrate between 70 to 79 years old, The population of group on diverticulum’edge most concentrate between 60 to 69 years old.2. Three groups have no statistical difference of gallstones’number and largest diameter, and complications.3. The location of JPD and duodenal papilla have influence on catheterization, when papilla is on the outside of diverticulum, catheterization is more difficult than the group that papilla is on the edge of diverticulum, but the impact is limited, the assisted catheterization technology can reduce influence.4. In each group, EST+ EPBD has the highest utilization rate and highest success rate.