ArticleBMC gastroenterology2023
A new classification of periampullary diverticulum: cannulation of papilla on the inner margins of the diverticulum (Type IIa) is more challenging.
Article in BMC gastroenterology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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10 citing papers in PubMed, 11 citations in OpenAlex.
- Article
- Transpancreatic precut sphincterotomy during ERCP: Learnability and outcomes across operator volumes and experience.Endoscopy international open · 2026Article
- Technical factors associated with biliary cannulation success after transpancreatic precut sphincterotomy.Endoscopy international open · 2026Article
- A stepwise cannulation strategy for conservative endoscopists: the clinical impact of transpancreatic precut after pancreatic stenting in a retrospective study from Taiwan.Clinical endoscopy · 2026Article
- Impact of periampullary diverticulum and relevant cannulation techniques on the outcomes of endoscopic retrograde cholangiopancreatography: a retrospective study.BMC gastroenterology · 2025Article
- Early precut is useful for difficult bile duct cannulation, particularly in cases with long oral protrusion.World journal of gastrointestinal endoscopy · 2025Article
- Association of periampullary diverticulum types with post-ERCP hyperamylasemia: a retrospective observational study.BMC gastroenterology · 2025Observational
- Outcomes of bile duct cannulation using a novel contrast-enhanced catheter: A single-center, retrospective cohort study.World journal of gastrointestinal endoscopy · 2025Article
- Precut Over a Pancreatic Duct Stent Versus Transpancreatic Precut Sphincterotomy for Difficult Biliary Cannulation in Endoscopic Retrograde Cholangiopancreatography: A Retrospective Cohort Study.Digestive diseases and sciences · 2024Article
- The impact of periampullary diverticula on cannulation and adverse events in endoscopic retrograde cholangiopancreatography.Therapeutic advances in gastroenterology · 2024Article
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11 authors at 3 institutions in 1 country.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundPeriampullary diverticulum (PAD) may make the performance of endoscopic retrograde cholangiopancreatography (ERCP) in patients with choledocholithiasis more difficult and may increase complication rates. The present study evaluated the effects of PAD on first-time ERCP in patients with choledocholithiasis.
methodsOutcomes were compared in patients with and without PAD and in those with four types of PAD: papilla located completely inside the diverticulum (type I), papilla located in the inner (type II a) and outer (type II b) margins of the diverticulum; and papilla located outside the diverticulum (type III). Parameters compared included cannulation time and rates of difficult cannulation, post-ERCP pancreatitis (PEP) and perforation.
resultsThe median cannulation times in patients with types I, II a, II b, III PAD and in those without PAD were 2.0 min, 5.0 min, 0.67 min, 3.5 min, and 3.5 min, respectively, with difficult cannulation rates in these groups of 7.4%, 31.4%, 8.3%, 18.9%, and 23.2%, respectively. The rates of PEP in patients with and without PAD were 5.3% and 5.1%, respectively. Four patients with and one without PAD experienced perforation.
conclusionsThe division of PAD into four types may be more appropriate than the traditional division into three types. Cannulation of type I and II b PAD was easier than cannulation of patients without PAD, whereas cannulation of type II a PAD was more challenging. PAD may not increase the rates of PEP.
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