Effect Of Juxtapapillary Duodenal Diverticulum In Patients With Common Bile Duct Stones During ERCP Operation

Objective To investigate the relationship between juxtapapillary duodenal diverticulum(JPD)incidence and age.To evaluate the impact on success rate with different parts of the diverticulum nipple in ERCP procedure and the rate of postoperative complications.Methods Through a retrospective analysis of 313 cases of common bile duct calculi which underwent endoscopic retrograde cholangiopancreatography(ERCP)treatment in our hospital from January2015 to August 2016 a total.Results A total of 313 patients,include 147 men and 166 women.Age range from 19 years to 90 years.Divided into two groups according to age,the number of the non elderly group(below the age of 60 years)was 141,the number of the elderly group(greater than or equal to the age of 60),was 172,We found that the elderly group diverticulum incidence rate was 34.9%,13.5% higher than the non elderly group,the difference was significant(P <0.05),the success rate of intubation in diverticulum group is lower than that of non diverticulum group,the difference was significant(P < 0.05),the rate does not have significant difference occurred in diverticulum group and non diverticulum when referred with complications,(P > 0.05).According to the relationship between the diverticulum and diverticulum nipple,the patients divided into three groups: 1,in group: the nipple located in the papillary diverticulum nipple diverticulum.2,the lower left nipple diverticulum group:the nipple located in the lower left nipple diverticulum,referred to as the left group.3,the lower right nipple diverticulum group: the nipple located in the lower right nipple diverticulum right,referred to as the group.We found that the the success rate of three groups of intubation respectively: the lower left nipple diverticulum group was 100%,right below the nipple diverticulum group was 93.9%,diverticulum papilla in group was 78.6%,the difference was significant(P < 0.05).The incidence rates of postoperative complications,postoperative hyperamylasemia,pancreatitis after surgery,postoperative hemorrhage,postoperative infection had no significant difference(no cases of perforation complications occurred in all 313 patients).Conclusion For patients with common bile duct stones underwent ERCP surgery,we found more JPD in elderly patients,the existence of diverticulum increase the difficulty of intubation,especially the diverticulum papilla intubation is the most difficult and had the lowest success rate,but with the appropriate choice of suitable operation mode under the premise of the existence of the diverticulum,the incidence of postoperative complications is not significantly affected.Therefore,ERCP treatment is a safe and effective means to treat common bile duct stones coexist with juxtapapillary duodenal diverticulum.