Abstract: Objective The aim of this study was to analyze the impact of periampullary diverticula (PAD) on surgical efficacy of endoscopic retrograde cholangiopancreatography (ERCP) in dealing with patients with choledocholithiasis. Methods A total of 275 patients with choledocholithiasis were admitted to our hospital between December 2016 and December 2019, and the presence of PAD were found in 101 patients, a papillary diverticulum in 37 cases and non-papillary diverticulum in 64 cases. All patients underwent ERCP for removal of stones. Results The success rates of intubation in patients with PAD and without PAD were 95.1% and 98.4%, respectively, and the success rates of stone removal in the two groups were 91.1% and 92.0%, respectively (P>0.05); the total incidence rate of postoperative complications was 19.8% in patients with and was 19.0% in patients without PAD (P>0.05); the success rate of intubation and success rate of stone removal in patients with papillary diverticulum were significantly lower than those with non-papillary diverticulum (86.5% vs. 100.0% and 81.1% vs. 96.9%, respectively, P<0.05); the total incidence rate of postoperative complications in patients with papillary diverticulum was 24.3%, not significantly different compared to 17.2% in patients with non-papillary diverticulum (P>0.05). Conclusion PAD has a certain influence on surgical intubation of ERCP for treatment of patients with choledocholithiasis, especially in those with papillary diverticulum, which could increase the difficulty of intubation and reduce the success rate of stone removal. The clinicians should practice for it as proficiently as possible.

Key words: Choledocholithiasis, Periampullary diverticula, Endoscopic retrograde cholangiopancreatography, Therapy