Japan Digestive Disease Week 2025
Invited Lecture (JGES)
November 01, 14:00–14:30, Room 12 (Kobe International Conference Center Main Hall)
Invited Lecture-7
Focusing on the relationship between periampullary diverticulum and pancreaticobiliary diseases for 20 years
- The First Hospital of Lanzhou University
Periampullary diverticulum (PAD) is a common anatomical variation of the duodenum, and with the development of imaging and endoscopic techniques, the clinical finding rate ranges from 6% to 31.7%. In 1988, Kennedy RH first proposed a significant association between periampullary duodenal diverticula and choledocholithiasis. We have been following PAD for 27 years since 1998. And we have carried out relevant clinical studies and experience summary around many issues.
Our study included as following: endoscopic treatment value analysis of choledocholithiasis with periampullary diverticulum, surgical options for periampullary diverticulum with recurrence of choledoolithiasis, the periampullary diverticulum is an important factor in the occurrence and recurrence of bile duct stones, endoscopic treatment strategy for periampullary diverticulum with choledocholithiasis, sedation, and analgesic anesthesia may reduce the ERCP-related complications in patients with periampullary diverticulum, effect of PAD on ERCP cannulation and its complications: a meta-analysis, The Li-tanaka classification which was proposed by Li Xun and Kiyohito Tanaka and its guiding implications for ERCP cannulation, comparison of clinical characteristics and effects on ERCP procedures in PAD in different regions, effect of PAD on stone composition and biliary microflora, how to reduce the recurrence of common bile duct stones in patients with PAD during ERCP procedure?
In summary: the incidence of PAD increases with age, which is closely related to the occurrence and recurrence of common bile duct stones, which increases the difficulty of stone removal for bile duct stones; Li-Tanaka classification of PAD is important guidance for ERCP cannulation and treatmen; PAD affects bile composition and bacterial flora, thus affecting stone occurrence and recurrence; 100 ml normal saline biliary irrigation after mechanical lithotripsy can effectively reduce the stone recurrence rate for the patients with PAD.
Our study included as following: endoscopic treatment value analysis of choledocholithiasis with periampullary diverticulum, surgical options for periampullary diverticulum with recurrence of choledoolithiasis, the periampullary diverticulum is an important factor in the occurrence and recurrence of bile duct stones, endoscopic treatment strategy for periampullary diverticulum with choledocholithiasis, sedation, and analgesic anesthesia may reduce the ERCP-related complications in patients with periampullary diverticulum, effect of PAD on ERCP cannulation and its complications: a meta-analysis, The Li-tanaka classification which was proposed by Li Xun and Kiyohito Tanaka and its guiding implications for ERCP cannulation, comparison of clinical characteristics and effects on ERCP procedures in PAD in different regions, effect of PAD on stone composition and biliary microflora, how to reduce the recurrence of common bile duct stones in patients with PAD during ERCP procedure?
In summary: the incidence of PAD increases with age, which is closely related to the occurrence and recurrence of common bile duct stones, which increases the difficulty of stone removal for bile duct stones; Li-Tanaka classification of PAD is important guidance for ERCP cannulation and treatmen; PAD affects bile composition and bacterial flora, thus affecting stone occurrence and recurrence; 100 ml normal saline biliary irrigation after mechanical lithotripsy can effectively reduce the stone recurrence rate for the patients with PAD.