Surgical Management of Pancreaticobiliary Disease associated with Juxtapapillary Duodenal Diverticula: Case Series and Review of the Literature

Juxtapapillary duodenal diverticula (DD), although usually asymptomatic, are occasionally associated with pancreaticobiliary conditions such as recurrent bile duct stones, cholangitis, and pancreatitis. An unusual case of DD associated with a dorsal duct stricture in a patient with recurrent pancreatitis and pancreas divisum is presented along with three additional instances of surgically treated DD and a review of the literature. The role of surgical intervention depends upon the specific nature of the presentation and the anatomical relationship of the diverticulum to the ampullary and pancreaticobiliary ductal system. Operations that divert bile and the food stream from DD are preferred over diverticulectomy.