Management of ERCP-related small bowel perforations: the pivotal role of physical investigation.

Canadian Journal of Surgery. Journal Canadien De Chirurgie
Attila DubeczHubert J Stein

Abstract

Management of endoscopic retrograde cholangiopancreatography (ERCP)-associated duodenal perforation remains controversial. Some recommend surgery, while others recommend conservative treatment. A retrospective chart review was conducted to identify patients treated at our institution for ERCP-related duodenal perforations. Study variables included indication for ERCP, clinical presentation, diagnostic procedures, time to diagnosis and treatment, location of injury, management, length of stay in hospital and survival. Between January 2000 and October 2009, 12 232 ERCP procedures were performed at our centre, and perforation occured in 11 patients (0.08%; 5 men, 6 women, mean age 71 yr). Six of the perforations were discovered during ERCP; 5 required radiologic imaging for diagnosis. Three perforations were diagnosed incidentally by follow-up ERCP. In 1 patient, perforation occurred 3 years after the procedure owing to a dislocated stent. Four of 11 perforations were stent-related; in 2 patients ERCP was performed in a nonanatomic situation (Billroth II gastroenterostomy). Free peritoneal perforation occurred in 4 patients; 1 was successfully managed conservatively. Four patients (36%) were treated surgically and none died. Five ...Continue Reading

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Citations

Aug 15, 2013·Current Gastroenterology Reports·Tom G Moreels
Oct 9, 2013·Gastroenterología y hepatología·Patricia Ruiz CuestaAntonio Naranjo Rodríguez
Jul 16, 2014·Der Chirurg; Zeitschrift für alle Gebiete der operativen Medizen·T Vowinkel, N Senninger
Jun 17, 2014·World Journal of Gastrointestinal Endoscopy·Dong Wook YuSeung Goun Hong
Jan 28, 2014·World Journal of Emergency Surgery : WJES·Richard C TurnerPeter Boyd
Jan 25, 2019·Journal of Laparoendoscopic & Advanced Surgical Techniques. Part a·Ding ShiYong Pan Liu
Oct 18, 2014·World Journal of Clinical Cases·Varayu Prachayakul, Pitulak Aswakul
May 17, 2013·Annals of the Royal College of Surgeons of England·M Ezzedien RabieA M Hummadi
May 18, 2018·Surgical Endoscopy·Jason G BillVladimir M Kushnir
Mar 13, 2019·Surgical Endoscopy·Nilesh Sadashiv PatilSundeep Singh Saluja

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