Perivaterian Diverticula Relationship to Biliary Tract Disease

Satoru Miyazaki, Tsuguo Sakamoto, Keishi Kuwata, Yoshirou Yamazaki, Hajime Yamazaki, Yoshikazu Morimoto, Hirokazu Kishima, Masahiro Tanemura, Masahiko Miyata*

Department of Surgery, Osaka Kosei-Nenkin Hospital
*The First Department of Surgery, Osaka University Medical School

Perivaterian duodenal diverticula has been known to cause biliary and pancreatic disorders. To establish a correlation between duodenal diverticula and biliary lithogenesis, we reviewed 12,321 patients who had an upper gastrointerstinal series and analyzed 467 patients who underwent biliary surgery during the at five years. The incidences of duodenal diverticula in males and females were 4.9% and 9.1%, respectively. 92.2% of the diverticula were located in the second duodenal portion, and 95.6% of them were solitary. The incidence of duodenal diverticula increased significantly with age. Common bile duct stones were highly associated with duodenal diverticula (17/33 cases,51.5%), in contrast to the lower incidence of diverticula in cases of gall bladder stones (51/329 cases, 15.8%) and polyps (8/49 cases, 16.3%). A significant correlation was also found between the diameter of the common bile duct and diverticula (r=0.43, p<0.05). The incidence of bilirubin stones in patients with diverticula was 84.4%, significantly higher than that in patients without diverticula (28.1%). The present study provided further evidence that duodenal diverticula contributed to biliary lithogenesis.

Key words
perivaterian diverticula, cholelithiasis, Lemmel syndrome

Reprint requests
Satoru Miyazaki Department of Surgery, Osaka Police Hospital
10-31 Kitayamachou, Tennoujiku, Osaka, 543 JAPAN

Accepted
January 13, 1993

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