Management of duodenal perforations after endoscopic retrograde cholangiopancreatography

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.