Surgical management of endoscopic retrograde cholangiopancreatography related injuries.

BACKGROUND/AIMS: The aim of this study was to determine timing and outcomes of surgical treatment options of endoscopic retrograde cholangiopancreatography (ERCP) related injuries.

METHODOLOGY: Nine patients with ERCP related injury were underwent surgical treatment at our institution. Data about these patients and outcomes of the treatment options used were retrospectively analyzed.

RESULTS

Out of 9 patients, 5 were female and mean age of 68.2 years (36-92 years). Out of 5 patients with duodenal injury (55.6%), 4 patients were treated with simple repair and 1 patient was treated with duodenostomy. Six patients were treated with pyloric closure and gastrojejunostomy. A T tube was placed in 5 patients with choledochal calculus and 1 patient with biliary fistula. One patient with a tumor in the periampullary region underwent pancreaticoduodenectomy. A total of 4 patients died (44.4%). Out of 5 patients followed, 5 (60%) had postoperative problems such as sepsis, wound infection and abdominal abscess. The mean hospital stay was 22.6±7.9 days.

CONCLUSION

Duodenal injuries should be treated with surgery immediately. Findings from physical examination and computed tomography should guide in making decisions about surgery. ERCP indications, type of injuries and abdominal inflammation should be kept in mind in decisions for the type of surgical treatment.