ERCP‐related perforations in the new millennium: A large tertiary referral center 10‐year experience

Abstract

Introduction: Endoscopic retrograde cholangiopancreatography (ERCP) is an important diagnostic and therapeutic modality for pancreatic and biliary disorders. Perforation is one of the most dreaded complications of ERCP. Since it is uncommon, there has been little study of incidence, risk factors, and outcomes of management. Objectives: We aim to assess the incidence of ERCP-related perforations and outcomes at a large tertiary referral center. Methods: We undertook a review of an ERCP database for all perforations from 2002 to December 2012. Results: The cumulative incidence of ERCP-related perforations was 0.14% (12 out of 8264), and sphincterotomy-related perforations constituted the most common cause. The mean age of these 12 patients was 58.6 years and majority were female (83.3%). The most common indications for ERCP were: suspected sphincter of Oddi dysfunction (SOD) 41%, and common bile duct stones (CBD stones) 41%. Nine of the 12 patients (75%) had a leak and were managed medically, and four who had a perforation had surgical repair (25%). Conclusions: In our study, leaks were much more common than perforations and the majority of patients were successfully managed with conservative therapy alone. We report a very low perforation rate and most perforations can be managed conservatively with a good outcome.

Surgical versus non-operative initial management of post-endoscopic retrograde cholangiopancreatography perforation: a systematic review and meta-analysis

“…The main characteristics of the included studies are presented in Table 1 . Nine retrospective studies [ 1 , 5 , 9 - 10 , 12 - 16 ] and a retrospective review of a prospective database [ 11 ] were included in the quantitative analysis. Table 1 also displays demographics information.…”

“…Table 1 also displays demographics information. Six of the included case-series [ 5 , 10 - 11 , 14 - 16 ] were scored as 8/9 and 4 studies [ 1 , 9 , 12 - 13 ] as 7/9 in the Case Series Quality Appraisal Checklist [ 8 ].…”

Complicaciones y factores de riesgo en pacientes sometidos a colagiopancreatografía retrógrada endoscópica en una clínica de tercer nivel de Medellín desde el 2014 hasta el 2017

“…En el presente estudio no se discriminó entre papilotomías antes o después del intento de canulación. En un estudio de 1.786 casos, la OR fue de 3,1 para la papilotomía y de 2,28 para la canulación del conducto de Wirsung 10 .…”

Non-Operative Management of Type 2 ERCP-Related Retroperitoneal Duodenal Perforations: A 9-Year Experience From a Single Center

“…In addition, radiologic interventions for percutaneous drainage of fluid collections make a non-surgical approach possible in these patients. There is increasing evidence that most type 2 retroperitoneal perforations could be managed without surgery [ 4 , 17 , 22 , 23 ]. After careful patient selection conservative management is successful in more than 90% of patients [ 10 ].…”