IS THE DIVERTICULARPAPILLA A FACTOR IN THE FAILURE OF CANULATION OF THE COMMON BILE DUCT IN BILIARY STONES PATHOLOGY?

Introduction: Duodenaldiverticulumiscommon (6-20%). Thesemaybe a difficulty in cannulation of the common bile duct and are more frequentassociatedwithbiliary stones.

Objectives: To calculate the prevalence of juxta-papillarydiverticulum in patients withbiliary stones and to evaluate the influence of juxtapillarydiverticulum on the success rate of the cannulation of the CBD in biliary stones pathology.

Patients and MethodsA prospspectivestudythat lead from April 2002 to september 2020. Wereincluded 1011 patients whobenefited of a ERCP for CBD stones. The presence or absence of a juxta-papillarydiverticulumwasnoted. Wecompared the success rate of cannulation of the common bile duct in patients with a juxta-papillarydiverticulum (Group I) versus patients withoutdiverticularpapillae (group II).

ResultsThe meanage of the patients was 58 ± 14 yearswith 605 women and 406 men (sex ratio M / F: 0.67). Patients withdiverticularpapillae (group I) accounted for 9.1% of the patients enrolled (93 patients). Group II had 918patients (90.8%). The success rate of the cannulation of CBD was 92.3% in group II versus 87.1% in group I (p: 0.04). The overall rate of early complications was 6% in group II versus 7.4% in group I (p = 0.11).

Conclusion The presence of a juxta-papillarydiverticulumappears to significantlydecrease the success rate of CBD cannulation in biliary stones pathologywithoutincreasing the risk of early complications. However, prospective studieswith large series are stillnecessary to confirmthese.