Excision of a juxtapapillary duodenal diverticulum causing biliary obstruction: report of three cases

Authors: Yoneyama, Fumihiko; Miyata, Kanji; Ohta, Hidemasa; Takeuchi, Eiji; Yamada, Tatsuharu; Kobayashi, Yoichiro

Source: Journal of Hepato-Biliary-Pancreatic Surgery, Volume 11, Number 1, February 2004 , pp. 69-72(4)

Publisher: Springer

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Abstract:

We report three cases of biliary obstruction caused by a juxtapapillary duodenal diverticulum that were treated by excision of the diverticulum. A 72-year-old man, a 77-year-old woman, and an 81-year-old woman each presented with recurrent obstructive jaundice. Diagnostic imaging revealed a juxtapapillary duodenal diverticulum compressing the common bile duct (CBD). Following cholecystectomy, the diverticulum between the intrapancreatic CBD and pancreatic parenchyma was isolated and excised successfully in each case. The patients have been followed up for 34, 31, and 22 months, respectively. In one patient, choledocholithiasis developed 33 months after the surgery, necessitating endoscopic sphincterotomy. Duodenal diverticulectomy is a useful procedure to relieve biliary obstruction caused by a juxtapapillary duodenal diverticulum. However, it remains unclear whether excision of the diverticulum is preferred to biliodigestive anastomosis from the point of view of long-term prognosis. Subsequent surveillance is necessary.

Keywords: Juxtapapillary duodenal diverticulum; Biliary obstruction; Surgical excision

Document Type: Research article

DOI: http://dx.doi.org/10.1007/s00534-003-0854-7

Affiliations: 1: Department of Surgery, Japanese Red Cross Nagoya First Hospital, 3-35 Michishita-cho, Nakamura-ku, Nagoya, 453-8511, Japan,

Publication date: 2004-02-01