Surgical treatment of duodenal diverticula: Is radical excision a harmful operation?

When duodenal diverticula are excised, additional surgery on the biliary tract is frequently required to remove stones and correct stenosis of the papilla of Vater. For this reason, a high rate of complications and deaths after diverticular resection was recorded in the '50s and '60s, and many surgeons recommended alternative operations. However, after the great improvement of biliary surgery in the last 15 years, this approach should be reviewed. In our experience, based on 12 patients, gastric cancer, biliary duct stones, cholelithiasis and papillary stenosis were associated with duodenal diverticula in 83% of the cases. All patients had excision of diverticula and 75% had associated operations on the gallbladder or biliary tract. There were 3 postoperative complications only and no deaths. Long term follow-up showed good results in 91% of the cases: only 1 patient had recurrent papillary stenosis and required further surgery. We think that resection of diverticula can be performed without any significant risk of severe complications and mortality.