Duodenal diverticula may cause difficulties with cannulation as the papilla may be located on the edge or rarely inside a diverticulum. Note relationship of papilla to duodenal diverticula. Periampullary diverticula and sphincterotomy Diverticula do not increase the risk of sphincterotomy unless the papilla is located on the edge or inside a large diverticulum. Cannulation may be technically more difficult and the risk of perforation is increased as a result of a deviated cut.
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