1. [Duodenal perforation post-ERCP: diagnostically and therapeutic management]
- Author
-
Fattori, L, Ardito, A, Germini, A, NESPOLI, LUCA CARLO, NESPOLI, ANGELO, Fattori, L, Nespoli, L, Ardito, A, Germini, A, and Nespoli, A
- Subjects
surgery ,Cholangiopancreatography, Endoscopic Retrograde ,ERCP ,Duodenum ,Intestinal Perforation ,duodenal perforation ,MED/18 - CHIRURGIA GENERALE ,Humans ,conservative treatment - Abstract
OBJECTIVE: Author's experience with periduodenal perforation after ERCP and there systematic approach is presented. METHODS: A retrospective study of 6 instances of duodenal perforation related to endoscopic retrograde cholangiopancreatography. The study follows these parameters: type of perforations, clinical presentation, diagnostic methods, time to diagnosis, methods of management, surgical procedures, length of stay, mortality and morbidity. RESULTS: Traditionally duodenal perforation after ERCP has been managed surgically; however in last decade management has been shifted to a more selective approach, but some authors promotes non surgical routine management: the reported death rate of medical treatment is high as 50%. In our experience an aggressive diagnostically and therapeutically management may reduce mortality. The decision to manage patients without surgery is a dynamic one and should undergo frequent reevaluation whenever the clinical circumstances demonstrate even the slightest untoward development. CONCLUSION: A selective management scheme and an aggressive but selective surgical approach may influence overall mortality
- Published
- 2007