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Rev Esp Enferm Dig. 2019 Feb 27;111. doi: 10.17235/reed.2019.5875/2018. [Epub ahead of print]

Management of duodenal perforations after endoscopic retrograde cholangiopancreatography.

Author information

1
Cirugía General y del Aparato Digestivo., Hospital General Universitario Reina Sofía de Murc, España.
2
Cirugía General y Digestiva, Hospital General Reina Sofía. Murcia, España.

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.

PMID:
30810327
DOI:
10.17235/reed.2019.5875/2018
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