Skip to main content
Annals of Surgery logoLink to Annals of Surgery
. 1982 Jul;196(1):30–32. doi: 10.1097/00000658-198207000-00007

Recurrent biliary calculi: duodenal diverticula as a predisposing factor.

T Løtveit, M Osnes, S Larsen
PMCID: PMC1352492  PMID: 6807222

Abstract

Several studies indicate a causal relationship between duodenal diverticula and gallstone disease. The diverticula persist after biliary tract surgery, and it is therefore presumed that patients with diverticula have an increased disposition to develop new calculi in the bile ducts after cholecystectomy. To test this hypothesis, the occurrence of recurrent biliary calculi was studied in 101 patients who had cholecystectomy, all with an asymptomatic period of two years or more following the primary biliary surgery. All patients had symptoms, that indicated biliary tract or pancreatic diseases. The incidence of recurrent calculi in patients with diverticula was 87.5% (95% confidence interval, 66.9-95.8). In patients without diverticula, the incidence was 31.9% (95% confidence interval, 21.5-44.3). The difference is highly significant, and the results support the assumption tht diverticula in the area of the papilla of Vater dispose to gallstone disease.

Full text

PDF
30

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Anderson J. R., Ross A. H., Din N. A., Small W. P. Cholelithiasis following peptic ulcer surgery: a prospective controlled study. Br J Surg. 1980 Sep;67(9):618–620. doi: 10.1002/bjs.1800670904. [DOI] [PubMed] [Google Scholar]
  2. Braasch J. W., Fender H. R., Bonneval M. M. Refractory primary common bile duct stone disease. Am J Surg. 1980 Apr;139(4):526–530. doi: 10.1016/0002-9610(80)90331-1. [DOI] [PubMed] [Google Scholar]
  3. Csendes A., Larach J., Godoy M. Incidence of gallstones development after selective hepatic vagotomy. Acta Chir Scand. 1978;144(5):289–291. [PubMed] [Google Scholar]
  4. Glenn F. Postcholecystectomy choledocholithiasis. Surg Gynecol Obstet. 1972 Feb;134(2):249–252. [PubMed] [Google Scholar]
  5. Gorbach S. L. Intestinal microflora. Gastroenterology. 1971 Jun;60(6):1110–1129. [PubMed] [Google Scholar]
  6. Lötveit T., Osnes M., Aune S. Bacteriological studies of common duct bile in patients with gallstone disease and juxta-papillary duodenal diverticula. Scand J Gastroenterol. 1978;13(1):93–95. doi: 10.3109/00365527809179812. [DOI] [PubMed] [Google Scholar]
  7. Løtveit T., Foss O. P., Osnes M. Biliary pigment and cholesterol calculi in patients with and without juxtapapillary duodenal diverticula. Scand J Gastroenterol. 1981;16(2):241–244. doi: 10.3109/00365528109181962. [DOI] [PubMed] [Google Scholar]
  8. Løtveit T., Osnes M., Aune S., Larsen S. Studies of the choledocho-duodenal sphincter in patients with and without juxta-papillary duodenal diverticula. Scand J Gastroenterol. 1980;15(7):875–880. doi: 10.3109/00365528009181545. [DOI] [PubMed] [Google Scholar]
  9. Madden J. L. Primary common bile duct stones. World J Surg. 1978 Jul;2(4):465–471. doi: 10.1007/BF01563675. [DOI] [PubMed] [Google Scholar]
  10. Maki T. Pathogenesis of calcium bilirubinate gallstone: role of E. coli, beta-glucuronidase and coagulation by inorganic ions, polyelectrolytes and agitation. Ann Surg. 1966 Jul;164(1):90–100. doi: 10.1097/00000658-196607000-00010. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Osnes M., Løotveit T., Larsen S., Aune S. Duodenal diverticula and their relationship to age, sex, and biliary calculi. Scand J Gastroenterol. 1981;16(1):103–107. [PubMed] [Google Scholar]
  12. Saharia P. C., Zuidema G. D., Cameron J. L. Primary common duct stones. Ann Surg. 1977 May;185(5):598–604. doi: 10.1097/00000658-197705000-00013. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Sapala M. A., Sapala J. A., Soto A. D., Bouwman D. L. Cholelithiasis following subtotal gastric resection with truncal vagotomy. Surg Gynecol Obstet. 1979 Jan;148(1):36–38. [PubMed] [Google Scholar]
  14. Tabata M., Nakayama F. Bacteria and gallstones. Etiological significance. Dig Dis Sci. 1981 Mar;26(3):218–224. doi: 10.1007/BF01391633. [DOI] [PubMed] [Google Scholar]
  15. van der Spuy S. The relationship between juxtapapillary diverticula and biliary calculi. An endoscopic study. Endoscopy. 1979 Sep;11(3):197–202. doi: 10.1055/s-0028-1098352. [DOI] [PubMed] [Google Scholar]

Articles from Annals of Surgery are provided here courtesy of Lippincott, Williams, and Wilkins

RESOURCES