Impact of periampullary duodenal diverticula on the occurrence and characteristics of pancreaticobiliary diseases: a comparative analysis

Abstract

Background and study aims

Periampullary diverticula (PAD), often detected incidentally during imaging or endoscopy, has been linked to pancreaticobiliary diseases. Previous studies focusing on ERCP patients may overestimate PAD prevalence and its association with these diseases. This study aimed to explore the relationship between PAD characteristics, including size and type, and the occurrence of pancreaticobiliary diseases.

Patients and methods

Patients who underwent gastroscopy at the Second Affiliated Hospital of Soochow University from January 2018 to December 2022 and were found to have PAD (PAD group) were selected. A control group of patients without PAD was matched by gender and age in a 1:3 ratio. The characteristics of PAD and its correlation with pancreaticobiliary diseases were analyzed.

Results

The detection rate of PAD was 0.73 %. A total of 389 patients in the PAD group and 1,167 in the control group were included. The incidence of pancreaticobiliary diseases was significantly higher in the PAD group compared to the control group (51.2 % vs. 32.6 %, P < 0.001). Elderly PAD patients (>60 years) had larger diverticula and a higher incidence of pancreaticobiliary diseases than non-elderly PAD patients (≤60 years). Among different types of PAD, Type I PAD patients had the highest incidence of gallbladder stones and acute pancreatitis. No statistically significant correlation was found between PAD size and pancreaticobiliary diseases, and the incidence of bile duct stones was lower in the giant diverticulum group.

Conclusion

The presence of PAD is significantly associated with pancreaticobiliary diseases, particularly in elderly PAD patients and those with Type I PAD, where there is a strong correlation with biliary diseases and acute pancreatitis.