Causes and Management of Endoscopic Retrograde Cholangiopancreatography-Related Perforation: A Retrospective Study

• DOI: 10.1272/jnms.jnms.2023_90-305
• Publication Date: 2023-06-01T22:14:47Z
• Authors: Tetsuya Shimizu; Masato Yoshioka; Akira Matsushita; Keiko Kaneko; Junji Ueda; Mampei Kawashima; Toshiyuki Irie; Takashi Ono; Hiroyasu Furuki; Tomohiro Kanda; Yoshiaki Mizuguchi; Yoichi Kawano; Yoshiharu Nakamura; Hiroshi Yoshida
• Keywords: Perforation

Endoscopic retrograde cholangiopancreatography (ERCP) is essential for diagnosing and treating biliopancreatic disease. Because ERCP-related perforation can result in death, therapeutic decisions are important. The aim of this study was to determine the cause suggest appropriate management.Between January 1999 August 2022, 7,896 ERCPs were performed our hospital. We experienced 15 cases (0.18%) conducted a retrospective review.Of patients, 6 female 9 male, mean age 77.1 years. According Stapfer's classification, comprised 3 type I (duodenum), II (periampullary), III (distal bile duct or pancreatic duct), no IV cases. Fourteen (92.6%) diagnosed during ERCP. main scope-induced damage, endoscopic sphincterotomy, instrumentation penetration I, II, cases, respectively. Four patients with severe abdominal pain extraluminal fluid collection underwent emergency surgery repair drainage. One patient distal cancer pancreaticoduodenectomy on day 6. Three only retroperitoneal gas computed tomography (CT) immediately after ERCP had symptoms needed additional treatment. Seven patents treated by nasobiliary drainage (n=5) CT-guided (n=2). There deaths, all discharged treatment.Early diagnosis treatment important managing perforation.