Clinical experience in the management of diagnosis and treatment of juxtapapillary diverticulum based on the use of ERCP

Abstract

Introduction. The weakest site of the duodenal wall is the ampulla of Vater, where the duodenal musculature is altered to form the sphincter of Oddi. This is the origin of duodenal diverticula that arise in the juxtapapillary region. Objective. was to report the experience in a high-density center where endoscopic retrograde cholangiopancreatography (ERCP) was performed and to understand the main diagnostic elements that allow suggesting the presence of juxtapapillary diverticulum (JPD) before reaching ERCP in the diagnosis of this pathology and, consequently, the ideal approach to follow in the main types of cases. Materials and methods. Retrospective study with an intentional sample, in which ERCP was performed on patients referred with different gastrointestinal pathologies, grouped according to their frequency, providing common elements that lead to the diagnosis of JPD, prior to the use of ERCP as a definitive diagnosis and subsequently the resolution of the problem. Results. Of the 13,451 patients who underwent ERCP between July 1, 2014 and December 18, 2024, a total of 963 patients were diagnosed with DYP by ERCP, with the main previous diagnoses being common bile duct stones, biliary tract dilatation, and abnormal liver function tests. Conclusions. Understanding the most common symptoms and symptoms in patients with DYP and how to resolve them allows for predicting the diagnosis of DYP, especially in countries with the greatest need, and for choosing the best solution to the problem after or during ERCP.