Recent advances in prevention and management of endoscopic retrograde cholangiopancreatography-related duodenal perforation

Wideochir Inne Tech Maloinwazyjne. 2021 Mar;16(1):19-29. doi: 10.5114/wiitm.2020.101025. Epub 2020 Nov 18.

Abstract

Endoscopic retrograde cholangiopancreatography (ERCP) is the main diagnosis and treatment for biliary and pancreatic diseases; however, ERCP requires a high level of technical skill and experience, and there is always a risk of complications. ERCP-related duodenal perforation is one of the most serious complications of ERCP, and although the incidence rate is relatively low, the mortality rate is high. Recently, the introduction of new classification methods and the development of endoscopic technology and equipment have made endoscopic therapy a new trend. This may change the management strategy of perforation. Therefore, we reviewed the latest developments in endoscopic management, surgical management, and conservative internal medicine management. In addition to introducing many new endoscope treatment methods, we also discussed the timing of interventions, the progress of endoscope and surgical indications, and corresponding prevention strategies. We aim to retrospectively analyse these treatment modalities to propose appropriate solutions to improve dynamic clinical therapy.

Keywords: duodenal perforation; endoscopic retrograde cholangiopancreatography; management; prevention strategy.

Publication types

  • Review