Abstract:
Duodenal diverticulas incidence is 10% of the total number of gastrointestinal tract
diverticulas, 70% being localized in D2 peri- or parapillary. These can affect all layers of the
duodenal wall or just the mucosa, which herniates through the weak points - vessel and common bile
duct penetration points in D2. One hundred and thirty four bilio-duodeno-pancreatic specimens
collected within 12 hours, from fresh human cadavers, with age range 18-85 years, without upper
gastrointestinal pathology, fixed in 10% formaline for 15 days were examined. Methods - anatomical
micro- and macropreparation, morphometry, common bile duct/duodenal angle measurement,
histotoporaphy and frequency appreciation of the pancreatic channel of the common bile duct were
performed. In 11.16% juxtapapillary diverticulas were observed Peripapillary diverticulas incidence -
67%, while parapapillary diverticulas incidence was 33%. Pancreatic channel was observed in 30%
and its length varied from 4 to 7 mm. In 75% the common bile duct/duodenal angle was 20°-45° and
in 25% - 20°-90°. The diameter of the common bile duct in the supraduodenal, pancreatic and
intramural portions was in the range 1-3 mm. The determining factors for distal common bile duct
stricture were: 1-diverticulary length; 2-diverticulary axe; 3-diverticulary diameter; 4-diverticulary
opening diameter. The anatomical particularities of the juxtapapillary diverticulas impair the biliary
tree drainage by compression of the distal part of the common bile duct. Under these circumstances
strictures, bile and wirsung stasis occurs with subhepatic jaundice, colangitis and chronic pancreatitis.
