Related Experiment Video
Updated: Jun 3, 2026
04:14
Laparoscopic Choledochal Cyst Excision and Roux-en-Y Choledochojejunostomy in Adults
Published on: February 28, 2025
Periampullary choledochal diverticula are not choledochal cysts
Dana C Moffatt1, Kathryn M Ziegler, Nicholas J Zyromski
1Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA. dmoffatt@sbgh.mb.ca
Gastrointestinal Endoscopy
|March 29, 2011
Summary
Small periampullary choledochal diverticula (PCD) appear to be acquired biliary anomalies, distinct from congenital choledochal cysts (CC). PCD are associated with sphincter of Oddi dysfunction and biliary hypertension, unlike CC.
Area of Science:
- Gastroenterology
- Hepatobiliary Surgery
- Biliary Tract Diseases
Background:
- Choledochal cysts (CC) are rare congenital biliary anomalies linked to malignancy.
- Small periampullary choledochal diverticula (PCD) are a newly identified biliary anomaly.
- PCD are primarily observed during ERCP procedures.
Purpose of the Study:
- To determine if PCD are congenital or acquired.
- Compare clinical presentation, management, and malignancy risk between PCD and CC.
- Differentiate PCD from CC for accurate classification and treatment.
Main Methods:
- Retrospective analysis of a medical center database (1985-2009).
- Compared data of 16 patients with PCD against 118 patients with CC.
- Reviewed ERCP, surgical pathology, billing, and imaging data.
Main Results:
- PCD patients were older, less likely female, and presented without jaundice compared to CC patients.
- PCD showed lower rates of anomalous pancreatobiliary junction and neoplasia, but higher rates of sphincter of Oddi dysfunction.
- PCD managed with ERCP (87%) vs. CC managed with surgery (80%); PCD had fewer long-term complications (6% vs. 40%).
Conclusions:
- PCD are likely acquired biliary anomalies, possibly secondary to biliary hypertension.
- PCD are frequently associated with sphincter of Oddi dysfunction.
- PCD should be distinguished from congenital choledochal cysts.
Related Concept Videos
01:27Diverticular Disease of the Colon
Diverticular disease involves the formation of diverticula—small sac-like outpouchings of the colonic wall—and their complications. It most commonly affects the sigmoid colon due to higher intraluminal pressure and structural vulnerability. It results from structural weakness and increased pressure in the colon, producing pseudodiverticula that may remain silent or progress to inflammation and serious complications.Structure of DiverticulaIn diverticulosis, these outpouchings are...
01:19Appendicitis
Appendicitis is an acute inflammatory condition of the vermiform appendix, most commonly caused by obstruction of its lumen. The appendix is a narrow, blind-ended pouch that extends from the cecum, making it particularly prone to obstruction. Causes include fecaliths, lymphoid hyperplasia (often after viral infections), parasites, tumors, or foreign bodies. This obstruction initiates a cascade of pathological changes.Luminal Obstruction and Early InflammationAfter obstruction, normal mucosal...
01:20Cholecystitis
Cholecystitis is inflammation of the gallbladder, most commonly caused by obstruction of the cystic duct. This blockage prevents bile from draining, leading to gallbladder distension, inflammation, and potentially serious complications. This condition may present acutely or chronically and can happen with or without gallstones.EtiologyAbout 95% of cholecystitis cases are calculous, caused by gallstones blocking the cystic duct, leading to bile accumulation and inflammation of the gallbladder...
01:17Gallbladder
The gallbladder is a small, pear-shaped organ that plays a crucial role in our digestive system. Measuring about 10 cm in length, it is comparable in size to a kiwi fruit and is located in a hollow area on the lower surface of the liver. The gallbladder's primary function is to store and concentrate bile, a fluid produced by the liver that aids in digestion.
The gallbladder's anatomy consists of three regions: the fundus, body, and neck. Extending from the neck, the cystic duct joins the common...
The gallbladder's anatomy consists of three regions: the fundus, body, and neck. Extending from the neck, the cystic duct joins the common...
01:22Appendicitis-I: Introduction
The appendix, a small, narrow, blind tube extending from the inferior part of the cecum, is widely regarded as a vestigial organ, having lost much of its original function through evolution. Despite its diminished role, the appendix can become inflamed, a condition known as appendicitis.
Etiology: Appendicitis can arise from various causes, primarily rooted in the obstruction of the appendix lumen. Factors contributing to this obstruction include fecal accumulation, lymphoid hyperplasia and, in...
Etiology: Appendicitis can arise from various causes, primarily rooted in the obstruction of the appendix lumen. Factors contributing to this obstruction include fecal accumulation, lymphoid hyperplasia and, in...
01:30Aneurysm I: Introduction
An aortic aneurysm is a localized outpouching or dilation at a weak point in the artery wall. It may involve different parts of the aorta, such as the abdominal aorta, aortic arch, or thoracic aorta.Etiological factorsSeveral disorders are associated with aortic aneurysms.Congenital causes, such as primary connective tissue disorders like Marfan syndrome, impact the integrity and strength of connective tissues, notably affecting the aorta. Marfan syndrome is a genetic disorder that specifically...