A study on periampullary diverticula – 6 years ERCP experience from a referral centre
Journal Title: International Archives of Integrated Medicine - Year 2018, Vol 5, Issue 6
Abstract
Introduction: Periampullary diverticula (PAD) are mucosal outpouchings commonly situated on the medial aspect of second part of duodenum; usually within 2-3 cm of the ampulla of vater. PAD are usually asymptomatic incidental findings during side viewing scopy. We aimed to analyze the influence of PAD in the management of patients who underwent ERCP during past 6 years in our centre. Materials and methods: Patients between the ages of 13 and 74 with the diagnosis of pancreaticobiliary diseases who underwent ERCP at Institute of medical gastroenterology, Madras Medical College from January 2012 to December 2017 were taken into account for retrospective analysis. We assessed and compared ERCP results in patients with and without PAD. Results: A total of 3412 patients underwent ERCP that of these 197(5.77%) patients had PAD. Among the 3412 cases , the incidences of PAD in patients age group less than 50 years was 2.6% and age group more than 50 years was 8.1%(P<0.001). Successful biliary cannulation was achieved in 79.18% (n=156) of patients with PAD and 93.1% of patients of patients without PAD (P<0.001). Of that in patients with PAD, for 28.93 %( n=57) cases underwent precut needle papillotomy. The papilla was undetectable in 6 cases with PAD. Incidence of PAD was higher in choledocholithiasis group (9.2% vs 4.1%, p=0.003), but in incidence of CBD stricture had no difference. Complete clearance of CBD stones was achieved lesser in patients with PAD (72.4% vs 86.8% P=0.02). Conclusion: The frequency of PAD increases with age and occurs more in choledocholithiasis cases. Our experience showed decreased rate of cannulation success with PAD, increased difficulty in cannulation and decreased rate of successful stone retrieval.
Authors and Affiliations
Rabindranath Eswaran, Premkumar Karunakaran, Allwin James, Venkateswaran Arcot Rajeswaran, Rajkumar Solomon
Keywords
Related Articles
- EP ID EP414941
- DOI -
- Views 95
- Downloads 0
A case report of papillary carcinoma thyroid in 34 years old female patient
Thyroid malignant tumors are rarely associated with hyperfunctioning thyroid. The incidence of this co-incidence is highly variable. Here we report a rare case of papillary thyroid cancer associated with hyperthyroidism...
Immunohistochemical study of p53 expression as proliferative index in neoplasia of the uterine cervix
Introduction: Cervical cancer is the third most common cancer in India. In women, it is the second most common after breast carcinoma. Human cancers arise from a protracted sequence of multiple genetic and epigenetic alt...
Comparison of various techniques in the management of fistula in ano
Introduction: Fistula in ano is the benign anorectal condition, but became a major problem for surgeons to cure the disease. For proper treatment of fistula in ano, a thorough knowledge of Anorectal anatomy and etiopatho...
Evaluation of etiopathological factors of intestinal obstruction and methods of prevention in a tertiary care hospital
Intestinal obstruction is an emergency condition which when unrelieved at the earliest will lead to strangulation and gangrene of the bowel. The aim of this study was to find the various causes for small intestinal obstr...
Pitfalls in the diagnosis of lesions of sinonasal tract both on clinical and histopathological grounds
Background: The nasal cavity and paranasal sinuses are collectively referred to as the sinonasal tract, which is anatomically and embryologically distinct from the nasopharynx. Aim and objectives: To understand the varia...