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[Prevalence of periampullary diverticular, its association with choledocolithiasis and technical sucess with ERCP]
Omar Edel Trujillo Benavides1, Enrique Paredes Cruz, Clovis Maroun Marun
1Servicio de Endoscopia Gastrointestinal, Hospital de Especialidades Dr Antonio Fraga Mouret del Centro Médico Nacional La Raza, IMSS. Ciudad de México. omaredel@hotmail.com
Background:
Periampullary diverticula (DP) are thought to be associated with bile duct stones; they may influence the index of success or failure at endoscopic retrograde cholangiopancreatography (CPE) and may increase the risk of its complications.
Aim:
Assess the association between DP with bile duct stones and its contribution with the technical success at CPE.
Methods:
Two hundred and forty five consecutive patients who were undergoing CPE between April 1st and September 23th were prospectively entered into a database. Patients with and without DP were identified and compared. DP prevalence, its association with bile duct stones and with the technical success at CPE, and immediate complications were determined. Chi squared, Student t and Fisher exact test were used.
Results:
A total of 205 cases were included. DP prevalence was 10. 7% (IC 95% 8.6-12.8) Mean age of patients with DP (68 vs. 52 years) (p = 0.001) and the incidence of choledocholithiasis (81% vs. 49%) (p = 0.004) were greater in DP group. There were no significant differences found between DP group and the control group in terms of successful duct cannulation (90% vs. 89%), satisfactory sphincterotomies (95% vs. 93%) or stone extraction (77% vs. 75%). There was an increased frequency of hemorrhage in the DP group (9% vs. 4%) however the difference was no significant.
Conclusions:
DP is associated with an increased incidence of choledocholithiasis. DP did not cause any major technical difficulties at CPE.
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