Surgical management of duodenal perforation after endoscopic retrograde cholangiopancreatography: case series

Background: Complications after endoscopic retrograde cholangiopancreatography (ERCP) are rare, approximately 0.09% to 1.8% are duodenal perforation. This type of injury requires early diagnosis and proper management since the outcomes can be catastrophic, leading to death in 20% of cases. Objective: To show our experience in the management of these injuries in order to establish if there is benefit from minimally invasive management versus conventional management. Method: Observational, retrospective and descriptive study comparing patients who required surgical management after post-ERCP duodenal perforation in three centers in Bogota, Colombia, between January 2013 and December 2018. Results: 13 patients were taken to surgical management after duodenal perforation post ERCP, 7 laparoscopically (53.8%), with an average hospital stay of 10.7 days and mortality of 0% and 6 by open route (46.1%), with an average hospital stay of 33 days and mortality of 50%, with a minimum follow-up of 6 months. Conclusions: Post ERCP duodenal perforation, despite its low incidence, should be suspected due to its high mortality. Laparoscopic surgery is a good tool to address duodenal perforations after ERCP, because it presents a lower rate of complications and mortality.

Automated summary

Laparoscopic surgery is an effective tool with lower complication and mortality rates for managing duodenal perforations after ERCP.