Year 2019 / Volume 111 / Number 4
Letter
Management of duodenal perforations after endoscopic retrograde cholangiopancreatography

331-333

DOI: 10.17235/reed.2019.5875/2018

Francisco Miguel González Valverde, Antonio José Fernández López,

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.
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05/11/2019 17:26:13
Un buen trabajo


References
1. Jiménez Cubedo E, López Monclús J, Lucena de la Poza JL et al. Revisión de las perforaciones duodenales tras colangiopancreatografía retrógrada endoscópica en el Hospital Puerta de Hierro de 1999 a 2014. Rev Esp Enferm Dig 2018; 110(8):515-519 DOI: 10.17235/reed.2018.5255/2017
2. Stapfer M, Selby RR, Stain SC et al. Management of duodenal perforation after endoscopic retrograde cholanfiopancreatography and sphincterotomy. Ann Surg. 2000; 232: 191-198.
3. Yu DW, Hong MY, Hong SG. Endoscopic treatment of duodenal fistula after incomplete closure of ERCP-related duodenal perforation. World J Gastrointest Endosc. 2014; 6(6):260-265.
DOI: 10.4253/wjge.v6.i6.260.
4. Salord S, Gornals JB, Maisterra S et al. Sellado endoscópico con clip OTSC de una perforación duodenal durante un drenaje biliar guiado por USE. Rev Esp Enferm Dig. 2012; 104: 489-90.
5. Palomeque Jiménez A, González Puga C, Pérez Cabrera B et al. Tratamiento conservador de la perforación duodenal tras realización de colangiopancreatografía retrograda endoscópica terapéutica. Gastroenterol Hepatol. 2015;38(4):285-6.
DOI: 10.1016/j.gastrohep.2014.03.016
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González Valverde F, Fernández López A. Management of duodenal perforations after endoscopic retrograde cholangiopancreatography. 5875/2018


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Publication history

Received: 18/08/2018

Accepted: 11/09/2018

Online First: 27/02/2019

Published: 04/04/2019

Article Online First time: 193 days

Article editing time: 229 days


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