Clinical Study Of Common Bile Duct Stone Complicated With Juxtapapillary Diverticulum For Therapeutic ERCP

Objective:To investigate the effect of Juxtapapillary diverticulum combined with common bile duct stones on therapeutic ERCP.Methods:A retrospective analysis was used to obtain data on 359 patients diagnosed as common bile duct stones in ERCP from March 2015 to November 2017 in our hospital.According to the presence or absence of juxtapapillary duodenal(JPD),they were divided into two groups,which were combined diverticulum group and non-combined diverticulum group.Among them,81 cases were combined diverticulum and 278 cases were non-combined diverticulum.The ERCP intubation rate,stone removal rate and postoperative complications were compared between the two groups.Results:The success rate of ERCP intubation was comparable between the two groups.75 cases were successfully intubated in the diverticulum group(intubation success rate was92.59%),and 269 cases were successfully intubated in the non-combined diverticulum group(intubation success rate was 96.76%).There was no difference between the two groups.Statistical significance(P>0.05).The success rate of stone removal by ERCP in the two groups was 81.The success rate was 97.53% in the combined diverticulum group.The success rate was 97.12% in the non-combined diverticulum group.There was no significant difference between the two groups(P>0.05).).The use rates of EST,EPBD,and EST+EPBD in the combined diverticulum group were 25.93%,13.58%,and 60.49%,respectively,and the stone success rates were 95.24%,100%,and 97.96%,respectively.Among them,EST combined with EPBD had the highest utilization rate.There was no statistical difference in the success rate of group stone removal(P>0.05).The incidence of complications in the two groups of patients was not statistically different from that of the non-combined diverticula group(P>0.05).Conclusion:1.The detection rate of JPD in therapeutic ERCP was 22.6%,which was related to the formation of common bile duct stones.2.JPD does not significantly affect the balloon dilation of the therapeutic ERCP cannula and the nipple.3.There is no correlation between the complications of therapeutic ERCP and JPD.