Choledocholithiasis characteristics with periampullary diverticulum and endoscopic retrograde cholangiopancreatography procedures: Comparison between two centers from Lanzhou and Kyoto

Table 1 Comparison clinical characteristics of choledocholithiasis patient with periampullary diverticulum between Lanzhou and Kyoto

Clinical Item	Lanzhou (n = 829)	Kyoto (n = 241)	P
Age (mean ± SD, yr)	64.6 ± 13.6	75.7 ± 12.1	< 0.001
Gender			0.48
Male	448 (54.0)	124 (51.5)
Female	381 (46.0)	117 (48.6)
Diameter of CBD (mean ± SD, mm)	14.8 ± 5.2	11.6 ± 4.2	< 0.001
Cholecystectomy	15.5 ± 5.2	13.1 ± 4.8	0.18
Gallbladder in situ	14.4 ± 5.1	11.5 ± 4.2	< 0.001
Proportion of CBD stone, n (%)			< 0.001
Single-stone	449 (54.7)	188 (79.7)
Multiple-stone	372 (45.3)	48 (20.3)
Maximum diameter of CBD stone (mean ± SD, mm)	12.2 ± 6.5	8.2 ± 5.3	< 0.001
Diameter (< 2cm), n (%)	718 (86.6)	233 (96.7)	< 0.001
Diameter (≥ 2cm), n (%)	111 (13.39)	8 (3.3)
Concomitant disease, n (%)
Acute cholangitis	153 (18.5)	23 (9.5)	0.001
Gallbladder stone	39 (4.7)	30 (12.5)	< 0.001
Obstructive jaundice	114 (13.8)	1 (0.4)	< 0.001
Acute pancreatitis	39 (4.7)	4 (1.7)	0.03
Pancreatic duct stones	1 (0.1)	0 (0.0)
Past medical history, n (%)
Operation Billroth I	0 (0.0)	3 (1.2)	0.01
Operation Billroth II	5 (0.6)	1 (0.4)	1.00
Cholecystectomy	318 (38.4)	9 (3.7)	< 0.001
Billary tract surgery	34 (4.1)	0 (0.0)	0.001

CBD: Common bile duct.

Table 2 Comparison of endoscopic retrograde cholangiopancreatography related contents of choledocholithiasis with periampullary diverticulum between Lanzhou and Kyoto

ERCP Item	Lanzhou (n = 829)	Kyoto (n = 241)	P
Intubation failure, n (%)	8 (1.0)	1 (0.4)	0.69
Intubation difficulty, n (%)	80 (9.7)	58 (24.1)	< 0.001
Difficulty to remove stone out, n (%)	290 (35.3)	127 (53.8)	< 0.001
Residual stone, n (%)	62 (7.6)	58 (24.6)	< 0.001
Procedure to duodenal papilla, n (%)
EST Only	419 (50.5)	217 (90.0)	< 0.001
EST + EPBD	352 (42.5)	1 (0.4)	< 0.001
EPBD only	14 (1.7)	0 (0.0)	0.049
Non-EST & non-EPBD	44 (5.3)	23 (9.5)	0.017
Post-complication (overall), n (%)	74 (8.9)	14 (5.8)	0.12
Acute cholangitis	22 (2.7)	1 (0.4)	0.035
Acute pancreatitis	49 (5.9)	8 (3.3)	0.11
Perforation	2 (0.2)	0 (0.0)	1.00
Bleeding	0 (0.0)	5 (2.1)	< 0.001

ERCP: Endoscopic retrograde cholangiopancreatography; EST: Endoscopic sphincterotomy; EPBD: Endoscopic balloon dilatation.

Table 3 Comparison of clinical characteristics of choledocholithiasis patient with and without periampullary diverticulum in Lanzhou or Kyoto

Clinical Item	Lanzhou (n = 2702)			Kyoto (n = 613)
	Non-PAD, n = 1873	PAD, n = 829	P	Non-PAD, n = 372	PAD, n = 241	P
Age, (median)	56.1 ± 16.9	64.6 ± 13.6	< 0.001	71.0 ± 15.0	75.7 ± 12.1	< 0.001
Gender, n (%)			< 0.001			0.22
Male	842 (45.0)	448 (54.0)		210 (56.4)	124 (51.4)
Female	1031 (55.1)	381 (46.0)		162 (43.6)	117 (48.6)
Proportion of CBD stone, n (%)			0.002			0.69
Single-stone	1131 (61.0)	449 (54.7)		298 (81.0)	188 (79.7)
Multiple-stone	724 (39.0)	372 (45.3)		70 (19.0)	48 (20.3)
Maximum diameter of CBD stone (mean ± SD, mm)	10.3 ± 5.4	12.2 ± 6.5	< 0.001	7.5 ± 5.2	8.2 ± 5.3	0.11
Diameter of CBD (mean ± SD, mm)	13.4 ± 5.1	14.8 ± 5.2	< 0.001	10.9 ± 3.6	11.6 ± 4.2	0.06
Cholecystectomy	14.5 ± 5.5	15.5 ± 5.2	0.008	11.3 ± 2.7	13.1 ± 4.8	0.25
Gallbladder in situ	12.7 ± 4.6	14.4 ± 5.1	< 0.001	10.9 ± 3.6	11.5 ± 4.2	0.07
Concomitant disease, n (%)
Acute cholangitise	260 (13.9)	153 (18.5)	0.002	39 (10.5)	23 (9.5)	0.71
Gallbladder stone	129 (6.9)	39 (4.7)	0.03	43 (11.6)	30 (12.5)	0.74
Obstructive jaundice	311 (16.6)	114 (13.8)	0.06	0 (0.0)	1 (0.4)
Past medical history, n (%)
Operation Billroth I	6 (0.3)	0 (0.0)	0.19	8 (2.2)	3 (1.2)	0.54
Operation Billroth II	5 (0.3)	5 (0.6)	0.19	4 (1.1)	1 (0.4)	0.65
Cholecystectomy	738 (39.4)	318 (38.4)	0.61	16 (4.3)	9 (3.7)	0.73
Billary tract surgery	89 (4.8)	34 (4.10)	0.45	0 (0.0)	0 (0.0)

PAD: Periampullary diverticulum.

Table 4 Comparison of endoscopic retrograde cholangiopancreatography related contents of choledocholithiasis patient with and without periampullary diverticulum in Lanzhou or Kyoto

ERCP Item	Lanzhou (n = 2702)			Kyoto (n = 613)
	Non-PAD, n = 1873	PAD, n = 829	P	Non-PAD, n = 372	PAD, n = 241	P
ERCP method, n (%)
EST Only	1084 (57.9)	419 (50.5)	< 0.001	326 (87.6)	217 (90.0)	0.36
EST and EPBD	627 (33.5)	352 (42.5)	< 0.001	4 (1.1)	1 (0.4)	0.65
EPBD only	47 (2.5)	14 (1.7)	0.19	4 (1.1)	0 (0.0)	0.16
Non-EST and non-EPBD	115 (6.1)	44 (5.3)	0.40	38 (10.2)	23 (9.5)	0.79
Curative effect, n (%)
Intubation failure	18 (1.0)	8 (1.0)	0.99	1 (0.3)	1 (0.4)
Intubation difficulty	152 (8.1)	80 (9.7)	0.19	121 (32.5)	58 (24.1)	0.02
Difficulty to remove stone out	482 (26.0)	290 (35.3)	< 0.001	196 (53.3)	127 (53.8)	0.89
Residual stone	123 (6.6)	62 (7.6)	0.39	86 (23.4)	58 (24.6)	0.73
Post ERCP complication, n (%)	152 (8.1)	74 (8.9)	0.48	37 (10.0)	14 (5.8)	0.07
Acute cholangitis	46 (2.5)	22 (2.7)	0.76	2 (0.5)	1 (0.4)	1.00
Acute pancreatitis	97 (5.2)	49 (5.9)	0.44	23 (6.2)	8 (3.3)	0.11
Perforation	4 (0.2)	2 (0.2)	1.00	3 (0.8)	0 (0.0)	0.28

ERCP: Endoscopic retrograde cholangiopancreatography; EPBD: Endoscopic balloon dilatation.