Mohammad Alizadeh Amir Houshang, Afzali Esmaeil Shamsi, Shahnazi Anahita, Mousavi Mirhadi, Doagoo Siavash Zafar, Mirsattari Dariush, Zali Mohammad Reza
Gastroenterology and Liver Diseases Research Center, Shahid Beheshti University of Medical Sciences, Tehran 19857, Iran.
ISRN Gastroenterol. 2013 Jul 28;2013:217261. doi: 10.1155/2013/217261. eCollection 2013.
Background. Although periampullary diverticulum is usually asymptomatic and discovered incidentally in patients during endoscopic retrograde cholangiopancreatography (ERCP), it may lead to post-ERCP morbidity. We compared baseline characteristics and clinical data as well as ERCP results in patients with and without periampullary diverticulum. Methods. Clinical, laboratory, and ERCP data of 780 patients referred to the Taleghani Hospital, as a great referral endoscopy center, in Iran were prospectively analyzed. Results. The periampullary diverticulum was identified in 44 patients (5.6%). Cannulation of common bile duct was more failed in patients with diverticulum compared to others (35.5% versus 11.5, P < 0.001). Patients with diverticulum had eight times more often common bile duct stone compared to patients without diverticulum (54.5% versus 12.2%, P < 0.001). Post-ERCP complications were observed in 2.3% and 4.2% of patients with and without diverticulum, respectively, which did not significantly differ in both groups. Conclusion. Because of more failure cannulation in the presence of periampullary diverticulum, ERCP requires more skills in these patients. Prevalence of common bile duct stone was notably higher in patients with diverticulum; therefore, more assessment of bile stone and its complications in these patients is persistently recommended.
背景。尽管壶腹周围憩室通常无症状，在内镜逆行胰胆管造影术（ERCP）检查时被偶然发现，但它可能导致ERCP术后发病。我们比较了有和没有壶腹周围憩室患者的基线特征、临床数据以及ERCP结果。方法。前瞻性分析了转诊至伊朗大转诊内镜中心塔莱哈尼医院的780例患者的临床、实验室和ERCP数据。结果。44例患者（5.6%）发现有壶腹周围憩室。与其他患者相比，憩室患者的胆总管插管失败率更高（35.5%对11.5%，P<0.001）。有憩室的患者胆总管结石发生率是无憩室患者的8倍（54.5%对12.2%，P<0.001）。有和没有憩室的患者ERCP术后并发症发生率分别为2.3%和4.2%，两组之间无显著差异。结论。由于存在壶腹周围憩室时插管失败率更高，ERCP对这些患者需要更多技巧。憩室患者胆总管结石的患病率明显更高；因此，持续建议对这些患者的胆结石及其并发症进行更多评估。
