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Introduction: Juxtapapillary duodenal diverticula are believed to create a technical difficulty at ERCP, and cause an increased number of complications following the procedure; however, data on this issue are conflicting. Aim of study: This study was conducted to find any association between common bile duct gallstones formation and the presence of juxtapapillary diverticulum and to assess effectiveness and safety of ERCP in this group of patients. Material and methods: The retrospective study was carried out on a group of 272 patients with biliary stone disease; 68 of them had diverticulum in the Vater's periampullary region. Results: The prevalence of common bile duct gallstones in patients with a juxtapapillary diverticulum was significantly higher as compared to control (65% vs. 49%; p=0.027). Cannulation of Vater's papilla was performed with comparable efficacy in both patient groups. The most common complication of ERCP was asymptomatic transient hyperamylasemia - more frequent among control (16.3% vs. 4.9%; p=0.024). Acute pancreatitis was the least common complication (1.5% vs. 3%; p=0.602). In the study and control group, clinically important bleeding after sphincterotomy was uncommon (0.5% vs. 4.4%; p=0.05). Conclusions: Patients with a diverticulum in the Vater's periampullary region develop biliary stone disease more frequently. It seems that neither cannulation efficacy, nor bile duct contrasting or the incidence of complications in the course of ERCP is affected. [ABSTRACT FROM AUTHOR]

This article describes the latest diagnostic and therapeutic recommendations in chronic pancreatitis, developed by the Working Group of the Polish Society of Gastroenterology and the Polish Pancreas Club. The recommendations refer to the diagnosis of chronic pancreatitis, autoimmune pancreatitis, conservative management, treatment of pain, and exocrine and endocrine pancreatic insufficiency, treatment of chronic pancreatitis by endoscopic and surgical methods, and oncological surveillance of chronic pancreatitis. This paper refers to the Polish recommendations published in 2011, which have been updated and supplemented. All recommendations were voted by experts of the Polish Society of Gastroenterology and the Polish Pancreas Club, who evaluated them each time on a five-degree scale, where I meant full acceptance, II - acceptance with some reservation, III - acceptance with serious reservation, IV - rejection with some reservation and V - full rejection. The results of the voting, together with a brief commentary, have been included with each recommendation put to the vote. In addition, the expert group assessed the value of clinical studies on which the statements are based, on a scale where A means high (based on meta-analyses and randomised clinical trials), B means medium (based on clinical trials and observational studies), and C means low (based mainly on expert opinion). [ABSTRACT FROM AUTHOR]