Abstract
The common causes of common bile duct dilatations are choledocholithiasis, histology of operative procedure of biliary system and chronic pancreatitis etc, but we have had six cases of common duct dilatations without any of the above changes for the past 3 years; these changes are usually recognized as primary benign papillary stenosis.
In all six cases, parapapillary diverticula were found at the second portion of duodenum by hypotonic duodenography.
All cases had been confirmed to having no bile duct stones at operation except one case who had a small gall bladder stone. The width of their common bile ducts were 10-20mm.
The pathological changes of our cases were various; such as; one case of opening orifice of the papilla of Vater at the inner wall of diverticulum, two cases of severe fibrosis of papilla (papillitis chronica fibrosa), one case of bending of the lower part of common duct pressured by diverticulum and of papillary insufficiency, one case of multiple diverticula and one case of abscess of gallbladder with papillary stenosis.
Relation between primary papillary lesion and parapapillary diverticulum seemed to be apparent in our six cases.
