[Diverticula of the duodenal window. 36 cases (author's transl)]

The authors have studied 36 cases of duodenal diverticula detected during 500 biliary operations. Initial pre-operative diagnosis was based on upper gastrointestinal barium series alone. Fiberopticduodenoscopy was unable to detect the diverticula. Patients were studied by cholangiocinesimetry. This technic demonstrated that oddian activity was satisfactory, with normal sphincter pressures and thus eliminated any suspicion of odditis. In this series, diverticula of the duodenal window lead to no more complications than do cholelithiasis, acute cholecystis or acute pancreatitis. The repercussion of the diverticula seems then to be limited to isolated dilatation of the common bile duct. In treating, the authors conclude that, in case of common bile duct dilatation, external drainage or biliodigestive anastomosis is recommended. Sphincterotomy is not indicated. All direct surgery on the diverticula, responsible for heavy morbidity and mortality rates, is to be avoided.