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Perforations ercp

Wei Liu, Lin-Ping Zhang, Mei Xu, Hong-Ze Zeng, Qi-Shan Zeng, Hong-Lin Chen, Qin Liu, Shou-Jiang Tang, Bing Hu
BACKGROUND AND STUDY AIMS: Ampullary impaction of an entrapped stone-basket complex is not an infrequent yet challenging event during endoscopic retrograde cholangiopancreatography (ERCP). The aim of this study is to evaluate the feasibility, safety, and efficacy of "post-cut" for the management of such scenarios. PATIENTS AND METHODS: Patients with impacted biliary stone with an entrapped basket during ERCP at West China Hospital, Chengdu, China, from October 2004 to August 2014 were included in this retrospective study...
March 5, 2018: Arab Journal of Gastroenterology: the Official Publication of the Pan-Arab Association of Gastroenterology
Mohammad Saud Khan, Faisal Jamal, Zubair Khan, Abhinav Tiwari, Hermann Simo, Himani Sharma
Duodenal perforation is a rare but life-threatening complication of endoscopic retrograde cholangiopancreatography (ERCP). Duodenal perforation can cause air leak into the extraperitoneal space. In rare instances, the air in the extraperitoneal space could dissect along the fascial planes of the abdomen to reach scrotum, leading to pneumoscrotum. We present the case of a 35-year-old male patient who developed scrotal pain and swelling following ERCP. He was found to have extensive pneumoscrotum, pneumoretroperitoneum, pneumomediastinum, and subcutaneous emphysema...
January 2018: Case Reports in Gastroenterology
Vijeta Pamudurthy, Raju Z Abraham, Thomas Betlej, Ashish Shah, Dong Kim, Brian Sasso, Abraham Chacko
Background and study aims  Endoscopic retrograde cholangiopancreatography (ERCP) is an invasive diagnostic and interventional procedure used in conditions related to the pancreas and biliary tract. It has a complication rate ranging from 4 % to 10 %. Severe complications are few with the most common of them being post-ERCP pancreatitis, post-sphincterotomy bleeding, and perforation. A rare, but potentially life-threatening complication of ERCP is splenic injury. We report the case of a 60-year-old female with choledocholithiasis who sustained splenic decapsulation following ERCP...
March 2018: Endoscopy International Open
Judith Staub, Ali Siddiqui, Linda Jo Taylor, David Loren, Tom Kowalski, Douglas G Adler
BACKGROUND AND AIMS: ERCP (endoscopic retrograde cholangiopancreatography) performed through previously placed enteral stents is an uncommon procedure without a significant amount of supporting literature, and with a wide reported range of technical success. The purpose of this study was to evaluate and better define the technical feasibility and safety of performing ERCP through enteral stents in patients with combined malignant biliary and gastric outlet obstruction (GOO). METHODS: We conducted a multicenter, retrospective study on 71 patients with combined gastric outlet and biliary obstruction who underwent ERCP through a previously placed enteral stent at 2 tertiary care centers...
February 6, 2018: Gastrointestinal Endoscopy
Guru Trikudanathan, Patrick Hoversten, Mustafa A Arain, Rajeev Attam, Martin L Freeman, Stuart K Amateau
Background and study aims : Management of post-sphincterotomy perforations is variable, with some patients managed conservatively and other requiring surgery. Fully-covered self-expanding metal stents (FCSEMs) have been used in the past, but data is limited. The aim of this study was to report the clinical characteristics and outcomes following placement of anchored FCSEMSs for the immediate management of post-sphincterotomy perforation. Patients and methods : All patients undergoing an ERCP procedure between June 2011 and December 2015 at our institution were reviewed for post-sphincterotomy perforation...
January 2018: Endoscopy International Open
Magdalena Plewka, Jacek Rysz, Kryzsytof Kujawski
Endoscopic retrograde cholangiopancreatography (ERCP) is a common procedure of the diagnosis and treatment of biliary and pancreatic diseases. ERCP combines both endoscopic and radiologic imaging. Despite the fact that it is widely considered as relatively safe and useful procedure when performed by an experienced endoscopist, ERCP may potentially result in complications due to its invasive nature. These complications vary in severity and include post-ERCP pancreatitis, cholangitis, hemorrhage and perforations of the gastrointestinal tract...
December 22, 2017: Polski Merkuriusz Lekarski: Organ Polskiego Towarzystwa Lekarskiego
Mazen R Al-Mansour, Eleanor C Fung, Edward L Jones, Nichole E Zayan, Timothy D Wetzel, Sara E Martin Del Campo, Anahita D Jalilvand, Andrew J Suzo, Rebecca R Dettorre, James K Fullerton, Michael P Meara, John D Mellinger, Vimal K Narula, Jeffrey W Hazey
BACKGROUND: Endoscopic retrograde cholangiopancreatography (ERCP) is a common procedure that, in the United States, is traditionally performed by gastroenterologists. We hypothesized that when performed by well-trained surgeons, ERCP can be performed safely and effectively. The objectives of the study were to assess the rate of successful cannulation of the duct of interest and to assess the 30-day complication and mortality rates. METHODS: We retrospectively reviewed the charts of 1858 patients who underwent 2392 ERCP procedures performed by five surgeons between August 2003 and June 2016 in two centers...
December 22, 2017: Surgical Endoscopy
James Weiquan Li, Tiing Leong Ang, Jia Wen Kam, Andrew Boon Eu Kwek, Eng Kiong Teo
Background: There is no consensus on what constitutes adequate training for needle knife precut sphincterotomy. Objective: The purpose of this study was to determine the number of procedures required before effective and safe precut sphincterotomy can be achieved. Methods: This retrospective study examined the cumulative experience of a single endoscopist from January 2006-December 2015. Precut sphincterotomy success and complication rates were analyzed as a function of number of procedures performed...
December 2017: United European Gastroenterology Journal
Gona Jaafar, Bahman Darkahi, Lars Lindhagen, Gunnar Persson, Gabriel Sandblom
BACKGROUND: Antimicrobial resistance may be promoted by divergent routines and lack of conformity in antibiotic treatment, especially regarding the practice of antibiotic prophylaxis. The aim of the present study was to assess differences in gallstone surgery regarding antibiotic use in Sweden. METHODS: The study was based on data from the Swedish Register for Gallstone Surgery and ERCP (GallRiks) 2005-2015. Funnel plots were used to test impact of grouping factors, including, hospital and surgeon and to identify units that deviated from the rest of the population...
December 6, 2017: BMC Surgery
Farhanul Huda, Manisha Naithani, Sudhir K Singh, Sarama Saha
Spontaneous perforation of extrahepatic biliary system is a rare and potentially fatal cause of acute abdomen. Clinical presentation is as biliary peritonitis. This condition is rarely suspected as a cause of peritonitis preoperatively and correct diagnosis is made during surgery. If suspected, diagnosis can be made by various imaging techniques like hepatobiliary scintigraphy, magnetic resonance cholangiopancreatography (MRCP), and endoscopic retrograde cholangiopancreatography (ERCP). As these imaging techniques are not readily available, especially in low socioeconomic countries, we hereby report a case of spontaneous common bile duct (CBD) perforation, which was diagnosed preoperatively by estimation of ascitic fluid-to-serum bilirubin ratio, a simple, quick, and cost-effective test...
July 2017: Euroasian Journal of Hepato-Gastroenterology
Pramod Nepal, Kosei Maemura, Yuko Mataki, Hiroshi Kurahara, Yota Kawasaki, Kiyokazu Hiwatashi, Satoshi Iino, Masahiko Sakoda, Takaaki Arigami, Sumiya Ishigami, Hiroyuki Shinchi, Shoji Natsugoe
BACKGROUND: Perforation of the horizontal duodenum is very rare due to the presence in retroperitoneal space. It depicts an unusual clinical picture and is difficult to diagnose, leading to increased morbidity and mortality. The treatment strategies are usually varied and based on small series of cases, literature reviews, and expert opinions. CASE PRESENTATION: Here, we presented three cases of horizontal duodenal perforation in three different clinical processes...
December 1, 2017: Surgical Case Reports
Zubair Khan, Umar Darr, Mohamad Nawras, Muhammad Bawany, Jacob Bieszczad, Osama Alaradi, Ali Nawras
Introduction: Endoscopic retrograde cholangiopancreatography (ERCP) has been proven to be a safe and effective method for diagnosis and treatment of biliary and pancreatic disorders. Major complications of ERCP include pancreatitis, hemorrhage, cholangitis, and duodenal perforation. We report a third case in literature of pneumoperitoneum after ERCP due to rupture of intrahepatic bile ducts and Glisson's capsule in a peripheral hepatic lesion. Case Report: A 50-year-old male with a history of metastatic pancreatic neuroendocrine tumor and who had a partially covered metallic stent placed in the biliary tree 1 year ago presented to the oncology clinic with fatigue, abdominal pain, and hypotension...
September 2017: Case Reports in Gastroenterology
G A Gómez-Torres, F M Rodríguez-Navarro, C R López-Lizárraga, C A Bautista-López, O S Ortega-García, G Becerra-Navarro, A Águila-Barragán, C F Ploneda-Valencia
INTRODUCTION: The spontaneous perforation of the biliary tract (SPBT) is an extremely rare cause of peritonitis, which was first described by Freeland in 1982, to date only around 70 cases have been reported. Here we present a case of spontaneous perforation of the biliary tract, in a patient with choledocholithiasis, which was treated with ultrasound-guided drainage and ERCP. CASE REPORT: A 51-year-old male was admitted to the emergency room for 15-day evolution jaundice, localized pain in the right flank and hypochondrium of 3days...
2017: International Journal of Surgery Case Reports
C J McCarthy, S R Butros, S L Dawson, R S Arellano
AIM: To evaluate the efficacy and safety of image-guided percutaneous drain placement for duodenal perforation following endoscopic retrograde cholangiopancreatography (ERCP). MATERIALS AND METHODS: A retrospective review of 7,249 ERCP examinations over a 10-year period was performed to identify cases of duodenal perforation. Indications for ERCP were documented, along with the clinical, laboratory, and imaging findings following perforation. Technical and clinical success of percutaneous drain placement was reviewed...
March 2018: Clinical Radiology
Abdelaziz Atwez, Matthew Augustine, James M Nottingham
INTRODUCTION: Non-traumatic biliary perforation other than the gallbladder is extremely rare and most commonly seen in children in association with congenital biliary anomalies. We present a rare case of choledocholithiasis that progressed to spontaneous perforation of the common hepatic duct probably from ischemic necrosis caused by impaction of large biliary stones. CASEREPORT: A 62-year-old female presented with diarrhea and jaundice. She was found to have two 2...
October 18, 2017: International Journal of Surgery Case Reports
Edson Guzmán-Calderón, Augusto Vera, Ramiro Díaz, Edgar Alva, Ronald Arcana
OBJECTIVE: To determine the efficacy and safety of double guidewire technique in patients with difficult biliary cannulation during ERCP. MATERIALS AND METHODS: We conducted a retrospective cohort study of all ERCPs performed between January 2015 and July 2016. DGT was performed in patients for whom biliary cannulation was difficult and guidewire insertion into the pancreatic duct (PD) was inadvertently achieved while attempting the standard WGC technique. RESULTS: 24 patients were enrolled with ERCP and DGT; 17 were female (70...
July 2017: Revista de Gastroenterología del Perú: órgano Oficial de la Sociedad de Gastroenterología del Perú
Masatake Nishiwaki, Chiemi Mizuno, Kota Yano, Hirohisa Oya, Ichiro Amano, Junko Matsumoto, Izumi Tanaka, Naoki Sawai, Masayuki Mizuno, Toshihide Shima, Yoshiharu Miyamoto, Takeshi Okanoue
An 85-year-old woman underwent endoscopic retrograde cholangiopancreatography (ERCP) for obstructive jaundice. Selective bile duct cannulation was unsuccessful because of periampullary diverticula (PAD). A pancreatic spontaneous dislodgement stent (PSDS) (5F diameter, 3 cm, straight type) was inserted to prevent post-ERCP pancreatitis. Three days after ERCP, she complained of abdominal pain, and computed tomography revealed retroperitoneal perforation because of PSDS migration to the PAD. If the papillary orifice is observed at the diverticular rim or in the diverticula, a pigtailed PSDS on the duodenal side or flanged stent on the pancreatic ductal side should be inserted in order to prevent this rare adverse event...
November 1, 2017: Internal Medicine
Osman Şimşek, Arife Şimşek, Sefa Ergun, Mehmet Velidedeoğlu, Kaya Sarıbeyoğlu, Salih Pekmezci
BACKGROUND: The goal of this study was to present our experience in the management of endoscopic retrograde cholangiopancreatography-related complications in patients referred to our surgical emergency unit by various endoscopy centers. METHODS: A retrospective investigation was conducted on the records of the 54 patients who were referred to our surgical emergency unit between October 2005 and January 2014 due to endoscopic retrograde cholangiopancreatography-related complications...
September 2017: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
Rocío Soler Humanes, Miguel Ángel Suárez Muñoz, Blanca García García
Nowadays endoscopic retrograde cholangiopancreatography (ERCP) is a minimally invasive technique with a complication rate around 2.5% in expert hands, being the most frequent: acute pancreatitis, cholangitis, hemorrhage and perforation. An exceptional complication is subcapsular hepatic hematoma, first published in the literature in 2000, with few cases reported. Regarding the case published by Del Moral Martínez et al (Hepatic Hematoma after ERCP: presentation of two new cases. Rev Esp Enferm Dig 2017, Vol...
November 2017: Revista Española de Enfermedades Digestivas
J T Thomson, M D Smith, J A O Omoshoro-Jones, J D Devar, P D Gaylard, Z K Khan, B J Jugmohan
BACKGROUND: Acute biliary pancreatitis is a significant cause of pancreatitis. The role and timing of endoscopic retrograde cholangiopancreatography in the setting of acute biliary pancreatitis is still controversial. Persistent choledocholithiasis in acute biliary pancreatitis occurs and establishing which patients require an endoscopic retrograde cholangiopancreatography based on liver function tests only can be challenging. METHOD: Retrospective analysis of the Chris Hani Baragwanath Academic Hospital's ERCP database was performed...
June 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
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