ArticleWorld journal of gastrointestinal endoscopy2025
Impact of periampullary diverticulum on the incidence of post-endoscopic retrograde cholangiography pancreatitis.
Article in World journal of gastrointestinal endoscopy, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundPeriampullary diverticulum (PAD) is a common anatomical variant, but its association with post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP) remains controversial. While PAD may alter ampullary anatomy, increasing technical difficulty during ERCP, existing studies report inconsistent findings on its role in PEP pathogenesis. We hypothesize that PAD presence, particularly type B, shows a significant association with PEP development and may interact with procedural factors like pancreatic duct guidewire insertion.
aimTo examine the association between PAD (including subtypes A/B) and PEP incidence after ERCP for choledocholithiasis.
methodsWe conducted a retrospective cohort study of 615 patients undergoing ERCP at two tertiary hospitals from 2023 to 2025. Participants were stratified into PAD (
resultsPAD prevalence was 29.8% (183/615). PEP occurrence was more frequent in PAD patients [15.3% (28/183)] than in non-PAD patients [4.2% (18/432)], odds ratio (OR) = 3.86, 95% confidence interval: 2.03-7.35,
conclusionPAD, particularly type B, is independently associated with PEP after ERCP. Patients with these features, especially those with hypertension or pancreatic duct instrumentation, may benefit from enhanced monitoring and prophylaxis.
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