Endoscopic treatment of ERCP-related duodenal perforation

Evans, N.; Buxbaum, James

doi:10.1016/j.tgie.2019.04.002

Cited by 5 publications

(5 citation statements)

References 73 publications

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“…Endoscopic repair of duodenal perforations, particularly small defects(<10mm) that are recognized during ERCP has been reported. 23 , 24 The latter development of endoscopic clipping (through-the-scope clips), suturing and closure devices (ligation band, fibrin glue, and endo-loops) as well as covering luminal stents has made endoscopy more efficient in treating injuries similar to perforations and bleeding. 25 – 31 With the growing body of evidence supporting the use of these techniques for the management of ERCP complications, endoscopist expertise, perforation type and diameter remain important predictors of the outcomes.…”

Section: Discussionmentioning

confidence: 99%

ERCP-induced perforation: review and revisit after half a century

A. Al Manasra,

Mesmar,

Manasreh

et al. 2024

F1000Res

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Background Endoscopic retrograde cholangiopancreatography (ERCP) is an invasive procedure. We aimed to investigate ERCP-induced perforations at our institution and conduct a comprehensive review of literature on ERCP-induced perforations (EIP) since the introduction of this procedure as a therapeutic intervention. Methods This was a case-control study, in which charts of all patients diagnosed with ERCP-induced duodenal perforation were reviewed and compared to a control group without perforation. Patient’s sociodemographic and clinical data, including ERCP procedure-related data, were gathered. Results A total of 996 ERCP procedures were performed; only 13 patients proved to have EIP. Obstructive jaundice was the most common indication for ERCP. The main predisposing factor was difficult cannulation (P = 0.003). In total, five patients required surgical treatment; the majority of them had type I perforation, whereas type IV was the most common in patients who were treated conservatively. The overall mortality rate was 15%, the surgical group had a slightly higher mortality rate. Conclusions Fifty years after the introduction of ERCP for therapy, it remains an invasive procedure that carries significant morbidity and mortality, even in skilled hands or at high- volume units. Conservative management of perforation yields favorable outcomes in selected patients.

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Section: Discussionmentioning

confidence: 99%

ERCP-induced perforation: review and revisit after half a century

A. Al Manasra,

Mesmar,

Manasreh

et al. 2024

F1000Res

View full text Add to dashboard Cite

show abstract

“…Endoscopic repair of duodenal perforations, particularly small defects(<10mm) that are recognized during ERCP has been reported. 23,24 The latter development of endoscopic clipping (through-the-scope clips), suturing and closure devices (ligation band, fibrin glue, and endo-loops) as well as covering luminal stents has made endoscopy more efficient in treating injuries similar to perforations and bleeding. [25][26][27][28][29][30][31] With the growing body of evidence supporting the use of these techniques for the management of ERCP complications, endoscopist expertise, perforation type and diameter remain important predictors of the outcomes.…”

Section: Discussionmentioning

confidence: 99%

ERCP-induced perforation: review and revisit after half a century

et al. 2023

View full text Add to dashboard Cite

Background: Endoscopic retrograde cholangiopancreatography (ERCP) is an invasive procedure. We aimed to investigate ERCP-induced perforations at our institution and conduct a comprehensive review of literature on ERCP-induced perforations (EIP) since the introduction of this procedure as a therapeutic intervention. Methods: This was a case-control study, in which charts of all patients diagnosed with ERCP-induced duodenal perforation were reviewed and compared to a control group without perforation. Patient’s sociodemographic and clinical data, including ERCP procedure-related data, were gathered. Results: A total of 996 ERCP procedures were performed; only 13 patients proved to have EIP. Obstructive jaundice was the most common indication for ERCP. The main predisposing factor was difficult cannulation (P = 0.003). In total, five patients required surgical treatment; the majority of them had type I perforation, whereas type IV was the most common in patients who were treated conservatively. The overall mortality rate was 15%, the surgical group had a slightly higher mortality rate. Conclusions: Fifty years after the introduction of ERCP for therapy, it remains an invasive procedure that carries significant morbidity and mortality, even in skilled hands or at high- volume units. Conservative management of perforation yields favorable outcomes in selected patients.

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“…Endoscopic repair of duodenal perforations, particularly small defects(<10mm) that are recognized during ERCP has been reported [23,24]. The latter development of endoscopic clipping (through-thescope clips), suturing and closure devices (ligation band, brin glue, and endo-loops) as well as covering luminal stents has made endoscopy more e cient in treating injuries similar to perforations and bleeding [25][26][27][28][29][30][31].…”

Section: Discussionmentioning

confidence: 99%

ERCP Induced Perforation; A Revisit After Half a Century

Manasra

Manasreh

Hammouri

et al. 2022

Preprint

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Background One of the most feared complications of endoscopic retrograde cholangiopancreatography (ERCP) is duodenal perforation. We aim to discuss the incidence and risk factors of ERCP induced perforation in light of pertinent literature and review therapeutic options of different perforation types. Methods In this case-control study, we reviewed the charts of all patients with ERCP-induced duodenal perforation between January 2016 and June 2020 and compared them to a control group without perforation. Data regarding patients’ demographics, comorbidities, indication for endoscopy, ERCP findings, presumed risk factors for complicated procedures, clinical presentation of perforation, radiologic findings, time to diagnosis and perforation type according to the Stapfer classification were collected. Treatment approach, additional interventions, length of hospital stay (LOS), morbidity and mortality were also documented. Results A total of 996 ERCP procedures were performed, 13 patients were diagnosed with ERCP-induced perforation (EIP). The most common indication for ERCP was obstructive jaundice. The most significant risk factor of duodenal perforation was failure or difficult cannulation (P = .003). 5 patients were treated surgically, the majority of them had type I perforation, whereas type IV was the most common in those treated conservatively. ICU admission rates and LOS in the ICU were higher among the surgical patients. The overall mortality rate was 15% with a slightly higher rate in the surgical group. Conclusion ERCP-induced duodenal perforation carries significant morbidity and mortality. Conservative management yields favorable outcomes in selected patients compared to the surgical approach.

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Endoscopic treatment of ERCP-related duodenal perforation

Cited by 5 publications

References 73 publications

ERCP-induced perforation: review and revisit after half a century

ERCP-induced perforation: review and revisit after half a century

ERCP-induced perforation: review and revisit after half a century

ERCP Induced Perforation; A Revisit After Half a Century

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