Background: In patients with a narrow-necked juxtapapillary diverticulum the endoscopic
cannulation of the papilla of Vater and the subsequent biliary therapy is sometimes
impossible.
Patients and Methods: Three patients referred for endoscopic retrograde cholangiography
and stone extraction were included. Earlier attempts to cannulate failed because visual
control was impeded by narrow-necked juxtapapillary diverticula with the papilla located
in the fundus. Endoscopic balloon dilation of the narrow diverticular neck, using
a 15-mm stone retrieval balloon, was carried out.
Results: In all three cases the papillary orifice was readily brought into view after
balloon dilation of the diverticular opening. Subsequent endoscopic treatment to the
bile duct was successful without any complications.
Conclusion: Balloon dilation of a narrow-necked juxtapapillary diverticulum is a safe
and easy procedure, which facilitates both cannulation of the papilla and subsequent
biliary endoscopic treatment.
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E. TóthM.D.
Endoscopy Unit
Dept. of Diagnostic Radiology
Malmö University Hospital
205 02 Malmö
Sweden
Phone: + 46-40-969977
Email: ervin.toth@rontgen.mas.lu.se