Endoscopy 2019; 51(04): S76
DOI: 10.1055/s-0039-1681394
ESGE Days 2019 oral presentations
Friday, April 5, 2019 17:00 – 18:30: ERCP cannulation 1 Panorama Hall
Georg Thieme Verlag KG Stuttgart · New York

THE ROLE OF THE JUXTAPAPILLARY DIVERTICULA IN ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY – BASED ON THE HUNGARIAN ERCP REGISTRY

T Bakucz
1   Medical Centre Hungarian Defence Forces, Department of Gastroenterology, Budapest, Hungary
,
Á Orbán-Szilágyi
1   Medical Centre Hungarian Defence Forces, Department of Gastroenterology, Budapest, Hungary
,
D Pécsi
2   University of Pécs, Institute for Translational Medicine, Medical School, Pécs, Hungary
,
S Gódi
3   University of Pécs, Division of Gastroenterology, First Department of Medicine, Pécs, Hungary
,
F Pakodi
3   University of Pécs, Division of Gastroenterology, First Department of Medicine, Pécs, Hungary
,
I Altorjay
4   University of Debrecen, Division of Gastroenterology, Second Department of Medicine, Debrecen, Hungary
,
G Kovács
4   University of Debrecen, Division of Gastroenterology, Second Department of Medicine, Debrecen, Hungary
,
Á Patai
5   Markusovszky University Teaching Hospital, Department of Gastroenterology and Medicine, Szombathely, Hungary
,
L Czakó
6   University of Szeged, First Department of Medicine, Szeged, Hungary
,
Z Szepes
6   University of Szeged, First Department of Medicine, Szeged, Hungary
,
P Hegyi
2   University of Pécs, Institute for Translational Medicine, Medical School, Pécs, Hungary
,
Á Vincze
3   University of Pécs, Division of Gastroenterology, First Department of Medicine, Pécs, Hungary
,
T Gyökeres
1   Medical Centre Hungarian Defence Forces, Department of Gastroenterology, Budapest, Hungary
› Author Affiliations
Further Information

Publication History

Publication Date:
18 March 2019 (online)

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Aims:

Contradictory data show that juxtapapillary diverticula could be frequently associated with bile duct stones, cannulation failure and higher rates of complications. In this study we compared success and complications of the ERCP's in patients with and without juxtapapillary diverticula based on our national ERCP registry.

Methods:

Data were collected prospectively from five Hungarian centers and contains the main information about the ERCP's and the 30-day follow-up periods.

Results:

In our cohort we found 1177 patients without (Group A) and 218 patients (Group B) with juxtapapillary diverticula. The mean age was 65 years vs. 72 years. The male-female ratio was 1:1.34 and 1:1.25. The main indications of ERCPs were almost the same in both groups (obstructive jaundice (29% vs. 23%), common bile duct stone (29% vs. 34%) and cholangitis (29% vs. 35%)). Cannulation failure was 4.74% vs. 5.22% in group A and B, which are acceptable based on the latest guidelines. There was only a minimal difference between the mean times of the whole ERCP procedures (18.64 min vs. 18.4 min). Surprisingly the mean cannulation time was shorter in the juxtapapillary group (3.16 min vs. 7.6 min). Intraprocedural bleeding that needed endoscopic intervention occurred in 4.74% vs. 3.36%, but only 0.87% vs. 0.75% required transfusion. The occurrence of perforation doesn't differ between two groups, 1.47% vs. 1.12%. The rate of post-ERCP pancreatitis was 1.73% vs. 1.12%, respectively. Cholangitis (2.07% vs. 3.73%) and cholecystitis (0.73% vs. 0.37%) were observed in both groups. Minor intraprocedural cardiovascular events occurred 3.07% vs. 4.85%. There was no significant difference in the rate of adverse events. The 30-day mortality was slightly high in both groups (5.87% vs. 3.36%), but only one case can be connected to the procedure in both groups.

Conclusions:

Based on these results the juxtapapillary diverticula can't be considered as a potential cause of cannulation failure or risk factor for complications.