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Management of ERCP-Related Perforations: Outcomes of Single Institution in Korea

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Journal of Gastrointestinal Surgery

Abstract

Introduction

The aim of this study was to analyze clinicoradiologic findings and treatment outcomes of patients with endoscopic retrograde cholangiopancreatography (ERCP)-related perforations. Between May 2003 and November 2007, 2,247 ERCP procedures with or without sphincterotomy were performed at Ajou University Medical Center, Suwon, Korea, and 20 perforations (0.89%) were identified.

Discussion

We retrospectively reviewed medical and surgical records of each patient. Of 18 patients, 11 patients (61.1%) underwent nonsurgical management, and seven patients (38.9%) received surgical management. There were no significant differences in age, gender, and laboratory findings between two groups (P > 0.05). The hospital stay was significantly longer in the operative group than that of the conservative group (P < 0.05, respectively). The most common cause of perforation was sphincterotomy (n = 8) in the conservative group whereas scope itself (n = 6) in operative group, showing a significant difference between the two groups (P < 0.05). The retroperitoneal air was most common findings in eight patients (72.7%) of the conservative group, while six (85.7%) patients of the operative group presented with intraperitoneal air, displaying a significant difference in location of air between the two groups (P < 0.05). Most of sphincterotomy-related perforations were managed nonsurgically. However, the scope-related perforations were usually large and required immediate surgery. Moreover, the delayed operation resulted in a longer hospital stay and high morbidity. Therefore, the selective early surgical intervention is suggested when scope-related perforations are discovered.

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Abbreviations

ERCP:

Endoscopic retrograde cholangiopancreatography

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Authors and Affiliations

  1. Department of Surgery, School of Medicine, Ajou University, San-5, Wonchondong, Yeongtonggu, Suwon, 442-749, South Korea

    Ji Hun Kim, Myung Wook Kim & Wook Hwan Kim

  2. Department of Gastroenterology, School of Medicine, Ajou University, Suwon, South Korea

    Byung Moo Yoo & Jin Hong Kim

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  1. Ji Hun Kim
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  2. Byung Moo Yoo
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  3. Jin Hong Kim
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Correspondence to Wook Hwan Kim.

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Kim, J.H., Yoo, B.M., Kim, J.H. et al. Management of ERCP-Related Perforations: Outcomes of Single Institution in Korea. J Gastrointest Surg 13, 728–734 (2009). https://doi.org/10.1007/s11605-008-0786-2

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