Abstract

Background: Endoscopic retrograde cholangiopancreatography (ERCP) is a preferred procedure in the treatment of common bile duct stones. However, the efficacy and safety of ERCP in patients with anatomical abnormalities such as peri-ampullary diverticulum have not been fully studied. This study aimed to evaluate the rate of successfull papillary cannulation, the results of CBD stone removal and the safety of ERCP in patients with CBD stones and periampullary diverticulum. Subjects and methods: Observational study of the efficacy of a technique, in 140 patients with CBD stones and periampullary diverticulum underwent ERCP from January 1, 2023 to December 31, 2023 at the Endoscopy Department of Cho Ray Hospital. Results: The successful rate of papillary cannulation after the first attempt was 95%, after the second attempt was 99.3%; 1.4% patients had bleeding during the procedure. The stones removal rate was 67.6%; Removing stones < 10mm was 94.6%, removing stones 10-15mm was 73.2%, removing stones 16-20mm was 23.8%, removing stones > 20mm were 20%. The rate of stones removal in the group with papilla located at the edge of the diverticulum was 68.6%, papilla next to the diverticulum was 100%, papilla located within the diverticulum was 55.6%. Conclusion: ERCP to remove CBD stones in patients with Peri-ampullary diverticulum was a fairly safe procedure with a high success rate of papillary cannulation. ERCP procedure in patients with papillae located at the edge of the diverticulum and next to the diverticulum had a higher rate of successful stone removal rate than those with papillae located in the diverticulum