Endoscopic clipping of a big periampullary perforation during endoscopic retrograde cholangiopancreatography

Abstract

Perforation is an uncommon but serious complication during endoscopic retrograde cholangiopancreatography (ERCP). The incidence of perforation though small but is the one that requires immediate management. Delay in identifying this complication can lead to severe morbidity and even mortality in selected cases. If one can identify a perforation during the procedure (ERCP), then the minimally invasive technique such as clipping of the perforation in expert hands can save a lot of additional operative procedures and additional hospital stay costs. We present one such case of large perforation during precut sphincterotomy in a case of difficult cannulation. The perforation was identified and successfully treated by clipping the perforation during the procedure which leads to quick recovery and short hospital stay.

Keywords

• clipping
• endoscopic retrograde cholangiopancreatography
• perforation
• precut sphincterotomy