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

作者：Kodali Sudha; Moenkemueller Klaus; Kim Hwasoon; Ramesh Jayapal; Trevino Jessica; Varadarajulu Shyam; Wilcox C Mel

来源：United European Gastroenterology Journal, 2015, 3(1): 25-30.

DOI：10.1177/2050640614560784

• ERCP perforation
• ERCP complication
• ERCP perforation management
• ERCP leak

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 dysSOD) 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.

• 出版日期2015-2