Impact of Periampullary Diverticulum on ERCP Outcomes and Recurrence of Common Bile Duct Stones.

IF 2.5 4区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Digestive Diseases and Sciences Pub Date : 2025-09-18 DOI:10.1007/s10620-025-09394-0

Xiaoxi Xie, Yanni Li, Yonghao Chen, Chong Geng, Yaoyu Guo, Xiao Li, Chunhui Wang

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引用次数: 0

Abstract

Purpose: This study was aimed to investigate the impact of periampullary diverticulum (PAD) on endoscopic retrograde cholangiopancreatography (ERCP) procedures and the recurrence of common bile duct stones (CBDS).

Methods: 830 CBDS cases with native papilla were finally enrolled in the study, including 239 cases with PAD (type I, type II, and type III). Procedures and complications of ERCP were compared between the two groups. The patients with successful stone removal were followed up every 6 months until December 31, 2023.

Results: The successful cannulation rate in the PAD group (96.7%) and type I PAD group (76.9%) was lower than that in the non-PAD group (99.2%). PAD was associated with a wider bile duct diameter, larger stone size, and a higher rate of cannulation with double guidewires, endoscopic sphincterotomy combined with endoscopic papillary balloon dilation and mechanical lithotripsy during the ERCP procedure. The incidence of complications did not differ between the two groups. Multivariate analysis revealed that PAD (OR = 3.265, 95%CI: 1.854-5.751) was an independent risk factor for the recurrence of CBDS.

Conclusion: PAD, especially type I PAD, may impact ERCP cannulation success rates. Additionally, PAD increases the complexity of stone extraction and is associated with CBDS recurrence.

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壶腹周围憩室对ERCP结果和胆总管结石复发的影响。

目的：本研究旨在探讨壶腹周围憩室（PAD）对内镜逆行胆管造影（ERCP）手术和胆总管结石（CBDS）复发的影响。方法：最终纳入830例具有天然乳头的CBDS病例，其中合并PAD的239例（I型、II型和III型）。比较两组ERCP的手术方法及并发症。结石取出成功的患者每6个月随访一次，至2023年12月31日。结果：PAD组（96.7%）和I型PAD组（76.9%）插管成功率均低于非PAD组（99.2%）。在ERCP手术中，PAD与胆管直径更宽、结石大小更大、双导丝插管率更高有关，内镜下括约肌切开术联合内镜下乳头球囊扩张和机械碎石术。两组的并发症发生率无差异。多因素分析显示，PAD （OR = 3.265, 95%CI: 1.854 ~ 5.751）是CBDS复发的独立危险因素。结论：PAD，尤其是I型PAD可能影响ERCP插管成功率。此外，PAD增加了结石取出的复杂性，并与CBDS复发有关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Digestive Diseases and Sciences 医学-胃肠肝病学

CiteScore

6.40

自引率

3.20%

发文量

420

审稿时长

1 months

期刊介绍： Digestive Diseases and Sciences publishes high-quality, peer-reviewed, original papers addressing aspects of basic/translational and clinical research in gastroenterology, hepatology, and related fields. This well-illustrated journal features comprehensive coverage of basic pathophysiology, new technological advances, and clinical breakthroughs; insights from prominent academicians and practitioners concerning new scientific developments and practical medical issues; and discussions focusing on the latest changes in local and worldwide social, economic, and governmental policies that affect the delivery of care within the disciplines of gastroenterology and hepatology.