Impact of Periampullary Duodenal Diverticula at Endoscopic Retrograde Cholangiopancreatography: A Proposed Classification of Periampullary Duodenal Diverticula

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To propose a classification schema to describe periampullary duodenal diverticula (PDD) found at endoscopic retrograde cholangiopancreatography (ERCP), and to study the characteristics of these diverticula.

Materials and Methods

Among 400 consecutive patients in whom an ERCP was performed, PDD were present in 131 (32.8%), being these patients significantly older than the remaining, served as controls.


PDD were classified in 3 different types according to the position of the major duodenal papilla: type I (16.3%), inside the diverticulum; type II (10.2%), in the margin of the diverticulum; and type III (6.5%), near the diverticulum. PDD were not associated with a more difficult cannulation of the biliary tract.


PDD are common, especially in older patients, and do not significantly increase the difficulty of deep cannulation.

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