[Endoscopic papillosphincterotomy in patients with para-ampullar diverticulosis]

It is suggested that the numerous variants of diverticula occurring in the region of the major duodenal papilla should be grouped into four types. Type I--the major duodenal papilla (MDP) is on the floor of the diverticulum; type II--the MDP is in the region of the lower ++semi-circumference of the diverticular orifice while the longitudinal fold runs radially on the wall of the diverticulum; type III--the MDP is in the region of the orifice of the diverticulum while the longitudinal fold does not pass on its wall; type IV--two diverticula located above the MDP to both sides of the longitudinal fold. Endoscopic papillosphincterotomy is considered contraindicated in patients with type I diverticulum. When indicated, the intervention was carried out in patients with types III and IV diverticula. Endoscopic papillosphincterotomy can be conducted in patients with type II diverticulum measuring more than 2 cm.