post ercp perforation 2016
TRANSCRIPT
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