POST ERCP

PERFORATION REVIEW

MANAGEMENT

ALGORITHM

TREATMENT

PROGNOSIS

UPDATE 2016 MIGUEL CHAVEZ ROSSELL MD

ARZOBISPO LOAYZA HOSPITAL

LIMA PERU

EPIDEMIOLOGY

Perforation rates with ERCP range from 0.1% to 0.6%

Risk Factors:

- Sphincterotomy

- Billroth II anatomy

- The intramural injection of contrast

- Prolonged duration of procedure

- Biliary stricture dilation

- SOD

- Malignancy

- Precut access

Complications of ERCP

There is no consensus in the treatment of this complication

Treatment and prognosis depends on

1. Type of perforation

2. Delayed diagnosis

3. Experience in the management of the complication (surgical team)

4. Advanced endoscopic technology

Should be considered early diagnosis of post-ERCP perforation, when

performed during ERCP, or in the recovery room.

CONCLUSIONS