Management of duodenal perforations after endoscopic retrograde cholangiopancreatography

Rev Esp Enferm Dig. 2019 Apr;111(4):331-333. doi: 10.17235/reed.2019.5875/2018.

Abstract

Objective: To describe our experience regarding post-endoscopic retrograde cholangio-pancreatography (ERCP) perforations and its conservative management.

Material and methods: Retrospective study of the therapeutic management of post-ERCP perforations occurred over the period 2012-2017 in our hospital.

Results: There were 12 perforations after ERCP, with choledocholithiasis being the main indication for the test (66.6%). In 9 cases (75%) an initial conservative attitude was attempted, but only 3 of them (25%) managed to solve the problem with broad-spectrum antibiotics, parenteral nutrition and close monitoring of the patient.

Discussion: Management of post-ERCP perforations must be individualized for each patient, depending on the clinical situation. Surgery remains the best option for the treatment of post-ERCP perforations, although conservative medical management is an option to be assessed, assuming that if it fails, delaying surgery is associated with high morbidity and mortality rates.

Publication types

  • Letter

MeSH terms

  • Cholangiopancreatography, Endoscopic Retrograde / adverse effects*
  • Cholangiopancreatography, Endoscopic Retrograde / statistics & numerical data
  • Conservative Treatment / statistics & numerical data*
  • Humans
  • Intestinal Perforation / etiology
  • Intestinal Perforation / therapy*
  • Retrospective Studies
  • Treatment Outcome