Incidence and significance of juxtapapillary diverticula at endoscopic retrograde cholangiopancreatography.

In a retrospective study of 755 atients undergoing endoscopic retrograde cholangiopancreatography from 1973 to 1977 at the Royal Free Hospital, 38 (5%) had a juxtapapillary diverticulum. This resulted in a significantly higher failure rate of cannulation of the ampulla of Vater (40 vs. 20% in the remainder of the group; p less than 0.02). The presence of a juxtapapillary diverticulum was also significantly associated with an increase of cholelithiasis (48 vs. 24%; p less than 0.01), and with jaundice or cholangitis developing after cholecystectomy (27 vs. 8%; p less than 0.001). There was no evidence that the diverticula were the cause of biliary or pancreatic obstruction.