ArticleBMC gastroenterology2025
Impact of periampullary diverticulum and relevant cannulation techniques on the outcomes of endoscopic retrograde cholangiopancreatography: a retrospective study.
Article in BMC gastroenterology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
3 citing papers in PubMed.
- Impact of Periampullary Diverticulum During ERCP: A Stone's Throw from Success?Digestive diseases and sciences · 2026Article
- Needle-knife precut techniques as the initial approach for biliary cannulation: is the evidence sufficient?Clinical endoscopy · 2026Article
- Impact of Papillary Morphology and Diverticular Type on Needle-Knife Papillotomy in Patients with Periampullary Diverticulum with Difficult Biliary Cannulation.Journal of clinical medicine · 2025Article
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Authors and funding
6 authors.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundPeriampullary diverticulum (PAD) is an incidental finding during endoscopic retrograde cholangiopancreatography (ERCP), occurring more frequently in elderly patients. The influence of PAD on the ERCP procedure has been a subject of debate. The aim of this study was to investigate the impact of PAD on ERCP outcomes.
methodsMedical records of patients with naïve papilla who underwent ERCP between 2022–2024 were retrospectively reviewed. Patients were classified into PAD and non-PAD groups. Patients with PAD were subclassified into three groups: type I, II, and II, with the location of papilla inside, at the margins, and outside the PAD. Cannulation success, ERCP findings, and adverse events were compared between the groups.
resultsA total of 179 and 884 patients were included in the PAD and non-PAD groups, respectively. After 1:1 propensity score matching (151 patients in each group), there was no significant difference between the PAD and non-PAD groups regarding the rate of successful biliary cannulation (96.7% vs. 98.0%, p = 0.361), difficult cannulation (49.0% vs. 40.4%, p = 0.132), successful stone extraction (85.8% vs. 93.0%, p = 0.64), and post-ERCP pancreatitis (PEP) (13.9% vs. 14.5%, p = 0.869). Additionally, there was no significant difference in the rate of PEP when the same cannulation techniques were compared between the two groups (p > 0.05). Among the three subtypes of PAD, no significant difference was observed in cannulation success and adverse event rates (p > 0.05).
conclusionsPresence of a PAD is not associated with increased risk of cannulation difficulty, procedural failure, or adverse events. Different cannulation techniques, if applied carefully and in accordance with the endoscopist's experience, could all be successful in patients with PAD.
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