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J.Jpn. Surg. Soc.. 86(9): 1138-1140, 1985


Report on the annual meeting

JUXTAPAPILLARY DUODENAL DIVERTICULA AND CHOLELITHIASIS

Second Surgical Division, School of Medicine, Kyoto University, Kyoto, Japan
*) Tsushimi Hospital, Kyoto, Japan

Kisaku Satomura, Tadakazu Yoh, Nobuaki Kobayashi, Kureo Tsushimi*)

One hundred and thirteen cases of juxtapapillary duodenal diverticula were found in 5573 cases which were examined by upper gastrointestinal barium meal X-ray examination. Seventy-nine percent of those 113 cases had complications, while 21% of the cases were suffered from juxtapapillary dudenal diverticula alone.
Among the complications, cholelithiasis showed the highest incidence. (33 casese out of 113 cases, 29.2%).
Twenty-four cases of juxtapillary duodenal diverticula of which serum amylase and serum bilirubin values were found to be over the normal range, were subjected to the ERCP and hepatocholedocal RI scintigraphy using 99mTcPI.
Fourteen cases out of the 24 cases had complication of cholelithiasis. In 4 cases (28.6%) in this group, delaying of bile-flow was observed. While in 3 cases (30%) out of 10 cases without cholelithiasis, bile-flow disturbance was found.
According to above mentioned observations, the following steps were recommended for the treatment of juxtapapillary duodenal diverticufla : 1. When juxtapapillary dudenal diverticula is revealed, examinations should be carefully done in order to find out other complications. 2. Treatment for juxtapapillary duodenal diverticula may be done simultaneously with operation of the complications. 3. Surgical indication of the juxtapapillary duodenal diverticula alone should be decided by the result of bile flow examination.


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