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

Fattori, L., Nespoli, L.C., Ardito, A., Germini, A., & Nespoli, A. (2007). Duodenal perforation post-ERCP: Diagnostically and therapeutic management. ANNALI ITALIANI DI CHIRURGIA, 78(3), 193-194.

Duodenal perforation post-ERCP: Diagnostically and therapeutic management

NESPOLI, LUCA CARLO;NESPOLI, ANGELO
2007

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
No
Articolo in rivista - Articolo scientifico
Scientifica
duodenal perforation; ERCP; surgery; conservative treatment
Italian
193
194
2
Fattori, L., Nespoli, L.C., Ardito, A., Germini, A., & Nespoli, A. (2007). Duodenal perforation post-ERCP: Diagnostically and therapeutic management. ANNALI ITALIANI DI CHIRURGIA, 78(3), 193-194.
Fattori, L; Nespoli, L; Ardito, A; Germini, A; Nespoli, A
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/10281/13769
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