Retrospective analysis of clinical approaches in cases of perforation after endoscopic retrograde cholangiopancreatography

Abstract

Endoscopic Retrograde Cholangiopancreatography (ERCP) is a procedure in which endoscopy and fluoroscopy are used together to diagnose and treat problems in the pancreatic and biliary ductal systems. According to published studies, the frequency of perforation associated with ERCP is reported to be less than 1%. In our study, we aimed to retrospectively analyze the data of patients we followed after ERCP perforation to examine treatment approaches. In this study, data from 33 patients who underwent ERCP at a tertiary stage education and research hospital between November 2016 and April 2021 and were identified to have developed perforation during or after the procedure were retrospectively evaluated. The indications and outcomes of ERCP for patients, as well as laboratory and imaging findings, were analyzed in detail. The age distribution of the 33 patients included in the study ranged from 20 to 83 years, with a mean age of 57.1±17.6 years. Perforation developed during the initial ERCP procedure in 66.7% of the patients, and on seven of the ten patients in whom perforation was detected during the procedure, interventions were performed during the procedure. Although the mortality rate in patients with Stapfer type 1 or type 2 perforations (33.3%) was higher compared to the patients with type 3 or type 4 perforations (11.1%), the observed difference was not found to be statistically significant. In conclusion, the management of patients with ERCP perforation should be approached in a multidisciplinary manner, and non-operative approaches should always be considered in the appropriate patient population. Closely and dynamically monitoring of patients and algorithmic approaches should standardized. [Med-Science 2024; 13(3.000): 736-42]

Keywords

• endoscopic retrograde cholangiopancreatography
• perforation
• complication
• stapfer classification
• clavien-dindo classification