The role of juxtapapillary duodenal diverticula in biliary stone disease

Background: Duodenal diverticula are acquired lesions found more often in older patients; when located near the major duodenal papilla they are called juxtapapillary. The prevalence of juxtapapillary duodenal diverticula (JDD) in the general population is around 20%; they are often associated with biliary lithiasis. This study assessed the association between JDD and biliary stone disease, particularly choledocholithiasis. Methods: Four hundred fifty ERCPs were performed in 420 patients from 1995 through 1999. The results for 300 ERCPs that were performed in 285 patients for suspected biliary lithiasis were analyzed. Results: JDD were present in 21.42% of the 420 patients; most were found in patients in the eighth and ninth decades of life. Patients with JDD had bile duct stones alone more often than patients without JDD (44% vs. 24%). According to their features, these bile duct stones were characterized as mainly primary. The existence of JDD influences bile duct diameter irrespectively of the presence of bile duct stones. Conclusions:JDD are important causative factors in the formation of bile duct stones.