Diagnosis and therapy of ERCP-related duodenal perforation: an analysis of 6 cases        TANG Jian, ZHANG Xi-wen, LI Fu. Department of Surgery, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200001,China
Corresponding  author: ZHANG Xi-wen, E-mail:zhangxw@sh163.net
Abstract    Objective    To study the prevention, diagnosis and treatment of periduodenal perforation related to endoscopic retrograde cholangiopancreatography (ERCP) by retrospective research. Methods    The clinical data of 6 cases of periduodenal perforation admitted from January 2006 to December 2010 in Renji Hospital, Shanghai Jiaotong University School of Medicine were analyzed retrospectively. Results    Of all the 6 cases, 5 cases were confirmed with bile duct stone, the other case had a mass on the head of the pancreas. Three cases received EST and nasol-biliary drainage after the procedure, in whom 2 cases were failed to cannulate and 1 case was failed for pre-spincterotomy was also failed. Another case developed periduodenal perforation directly by the duodenal scope. Two cases were treated conservatively. Four cases received open surgery, in whom 3 cases were fully-recovered and one died. Conclusion Postoperative careful observation, diagnosis on time and individual choice of reasonable treatment according to the different etiologies of perforation are the key factors to improve the results of periduodenal perforation related to ERCP.