Year 2025 / Volume 117 / Number 5
Letter
Minimally invasive management of persistent retroperitoneal infections following endoscopic retrograde cholangiopancreatography duodenal perforations

287-288

DOI: 10.17235/reed.2024.10522/2024

Xiaohan Jiang, Min Wang, Min Fu, Yajun Cheng, Lili Zhao, Zhining Fan,

Abstract
Duodenal perforation is the most serious complication of endoscopic retrograde cholangiopancreatography (ERCP), with an incidence of 0.09-1.67% but a high mortality rate of 8-23%. The Stapfer classification categorizes ERCP perforations into four types based on location: I) lateral/medial duodenal wall, II) perivaterian, III) distal bile duct related to instrumentation, IV) retroperitoneal air alone. While surgery is recommended for diagnosed perforations due to the mortality risk, there is no established treatment for resulting long-term retroperitoneal infections. We describe our experience managing such cases.
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References
1. R. Cirocchi et al., A systematic review of the management and outcome of ERCP related duodenal perforations using a standardized classification system. Surgeon 15, 379-387 (2017).
2. T. J. Howard et al., Classification and management of perforations complicating endoscopic sphincterotomy. Surgery 126, 658-663; discussion 664-655 (1999).
3. S. Alfieri et al., Management of duodeno-pancreato-biliary perforations after ERCP: outcomes from an Italian tertiary referral center. Surg Endosc 27, 2005-2012 (2013).
4. N. S. Patil, N. Solanki, P. K. Mishra, B. C. Sharma, S. S. Saluja, ERCP-related perforation: an analysis of operative outcomes in a large series over 12 years. Surg Endosc 34, 77-87 (2020).
5.García-Cano J. Fewer endoscopists should perform more ERCPs. Rev Esp Enferm Dig. 2023 Jul;115(7):353-356. doi: 10.17235/reed.2023.9507/2022
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Citation tools
Jiang X, Wang M, Fu M, Cheng Y, Zhao L, Fan Z, et all. Minimally invasive management of persistent retroperitoneal infections following endoscopic retrograde cholangiopancreatography duodenal perforations. 10522/2024


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Publication history

Received: 06/05/2024

Accepted: 19/05/2024

Online First: 22/05/2024

Published: 08/05/2025

Article Online First time: 16 days

Article editing time: 367 days


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