Association Between Juxtapapillary Duodenal Diverticula and Risk of Choledocholithiasis: A Systematic Review and Meta-Analysis

Abstract

1149_A Figure 1. Forest plot of this meta-analysisIntroduction:Background/Objectives: Studies have suggested that the presence of juxtapapillary duodenal diverticula (JDD) could be a predisposing factor for choledocholithiasis. JDD may interfere with biliary drainage by externally compressing the common bile duct which could predispose to bile stasis and stone formation. This systematic review and meta-analysis was conducted with the aims to summarize all available evidence to better characterize the risk. Methods: A literature search was performed using MEDLINE and EMBASE database from inception to January 2018. Cross-sectional studies that reported odd ratios (OR) comparing the risk of choledocholithiasis among individuals with JDD versus individuals without JDD were included. Pooled OR and 95% confidence interval (CI) were calculated using a random-effect, generic inverse variance method. Results: Of 527 retrieved articles, 11 studies met our eligibility criteria and were included in analysis. We found a significant association between the presence of JDD and choledocholithiasis with the pooled OR of 2.30 (95% CI, 1.84-2.86). The statistical heterogeneity was moderate with an I2 of 60%. Conclusion:Conclusions: A significantly increased risk of choledocholithiasis among individuals with JDD was observed in this study.1149_B Figure 2. Funnel plot of this meta-analysis