Open AccessPrimary endoscopic approximation suture under cap-assisted endoscopy of an ERCP-induced duodenal perforation
Author(s) -
Tae Hoon Lee,
Byoung Wook Bang,
Jee In Jeong,
Hyung Gil Kim,
Seok Jeong,
Seon Mee Park,
Don Haeng Lee,
SangHeum Park,
SunJoo Kim
Publication year - 2010
Publication title -
world journal of gastroenterology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.427
H-Index - 155
eISSN - 2219-2840
pISSN - 1007-9327
DOI - 10.3748/wjg.v16.i18.2305
Subject(s) - medicine , perforation , endoscopic retrograde cholangiopancreatography , endoscopy , surgery , complication , fibrous joint , pancreatitis , materials science , punching , metallurgy
Duodenal perforation during endoscopic retrograde cholangiopancreatography (ERCP) is a rare complication, but it has a relatively high mortality risk. Early diagnosis and prompt management are key factors for the successful treatment of ERCP-related perforation. The management of perforation can initially be conservative in cases resulting from sphincterotomy or guide wire trauma. However, the current standard treatment for duodenal free wall perforation is surgical repair. Recently, several case reports of endoscopic closure techniques using endoclips, endoloops, or fully covered metal stents have been described. We describe four cases of iatrogenic duodenal bulb or lateral wall perforation caused by the scope tip that occurred during ERCP in tertiary referral centers. All the cases were simply managed by endoclips under transparent cap-assisted endoscopy. Based on the available evidence and our experience, endoscopic closure was a safe and feasible method even for duodenoscope-induced perforations. Our results suggest that endoscopists may be more willing to use this treatment.