Periampullary duodenal diverticula and technical-therapeutic failure during endoscopic retrograde cholangiopancreatography (ERCP)
DOI:
https://doi.org/10.22516/25007440.706Keywords:
Duodenal diverticulum, periampullary, Endoscopic retrograde cholangiopancreatography, cannulation, Papilla of VaterAbstract
Introduction and aims: Periampullary duodenal diverticula (PDD) are rare and their finding is incidental. In addition, they are classified into three types according to Boix due to their proximity to the larger blister. The aim of this study was to describe our experience with this anatomical anomaly and to demonstrate how this affects the technical and therapeutic success rate of the procedure.
Materials and methods: A cross-sectional study was performed, with data collection retrospectively. Over a 5-year period of patients with duodenal periampullary diverticula. Therapeutic failure, complications and difficulty of cannulation of the bile duct were evaluated.
Results: 214 were assessed, with a women-men rate 2,15:1. The distribution of subjects by PDD was: Type I (29.9%), II (51.9%) y III (18. 2%). The most frequent indication of ERCP were the common bile duct stones at 53.3%. The PDD type I presented greater difficulty of cannulation (11.6%) and therapeutic failure (28.12%).
Conclusion: The presence of PDD during ERCP is associated with greater technical failure (failure in cannulation) and therapeutic failure (persistence of biliary obstruction). In addition, it is considerably increased when it is a Type I intradiverticular papilla of the Boix classification. Therefore, we suggest that biliary endoscopic procedures in these conditions be performed by endoscopists with great experience in order to minimize the probability of technical and therapeutic failure and associated complications.
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