Endoscopic Treatments of Endoscopic Retrograde Cholangiopancreatography-Related Duodenal Perforations.
- Author:
Tae Hoon LEE
1
;
Joung Ho HAN
;
Sang Heum PARK
Author Information
1. Division of Gastroenterology, Department of Internal Medicine, Soonchunhyang University Cheonan Hospital, Soonchunhyang University College of Medicine, Cheonan, Korea. thlee9@schmc.ac.kr
- Publication Type:Review
- Keywords:
Cholangiopancreatography, endoscopic retrograde;
Perforation;
Duodenum;
Therapeutics
- MeSH:
Cholangiopancreatography, Endoscopic Retrograde;
Duodenum;
Endoscopy;
Sphincterotomy, Endoscopic;
Stents
- From:Clinical Endoscopy
2013;46(5):522-528
- CountryRepublic of Korea
- Language:English
-
Abstract:
Iatrogenic duodenal perforation associated with endoscopic retrograde cholangiopancreatography (ERCP) is a very uncommon complication that is often lethal. Perforations during ERCP are caused by endoscopic sphincterotomy, placement of biliary or duodenal stents, guidewire-related causes, and endoscopy itself. In particular, perforation of the medial or lateral duodenal wall usually requires prompt diagnosis and surgical management. Perforation can follow various clinical courses, and management depends on the cause of the perforation. Cases resulting from sphincterotomy or guidewire-induced perforation can be managed by conservative treatment and biliary diversion. The current standard treatment for perforation of the duodenal free wall is early surgical repair. However, several reports of primary endoscopic closure techniques using endoclip, endoloop, or newly developed endoscopic devices have recently been described, even for use in direct perforation of the duodenal wall.
