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Impact of Periampullary Diverticulum on ERCP Performance: A Matched Case-Control Study
Juan E Corral1, Omar Y Mousa1, Paul T Kröner1
1Division of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, FL, USA.
Clinical Endoscopy
|August 22, 2018
Summary
Periampullary diverticulum (PAD) does not hinder endoscopic retrograde cholangiopancreatography (ERCP) success. This study found similar therapeutic outcomes for ERCP in patients with PAD compared to controls, including for gallstone removal.
Area of Science:
- Gastroenterology
- Endoscopic Procedures
- Biliary System Disorders
Background:
- Periampullary diverticulum (PAD) is common during ERCP and linked to bile duct stones.
- The impact of PAD on ERCP outcomes is debated.
- This study investigates PAD's effect on ERCP success.
Purpose of the Study:
- To compare the therapeutic success of ERCP in patients with PAD versus matched controls.
- To assess if PAD influences key ERCP procedural elements.
Main Methods:
- Retrospective review of 1,089 ERCP cases with PAD against 3,267 matched controls from a national database.
- Comparison of demographics, endoscopic findings, structure visualization, and success rates.
- Secondary analysis focused on gallstone disease treatment success.
Main Results:
- ERCP success rates were comparable between patients with and without PAD.
- Multivariate analysis showed no significant difference in outcomes.
- PAD presence did not impact sphincterotomy rates or visualization of biliary structures.
Conclusions:
- Periampullary diverticulum is not a significant impediment to ERCP success.
- Further research is required to optimize cannulation and therapeutic approaches for PAD subtypes.
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