Download PDF
CC BY-NC-ND 4.0 · Journal of Digestive Endoscopy 2016; 07(01): 027-029
DOI: 10.4103/0976-5042.180097
Case Report
Society of Gastrointestinal Endoscopy of India

Endoscopic clipping of a big periampullary perforation during endoscopic retrograde cholangiopancreatography

Amitabh Mohan Jerath
Department of Gastrosciences, Fortis Escorts Hospital, Amritsar, Punjab, India
,
Gurbilas P. Singh
Department of Gastrosciences, Fortis Escorts Hospital, Amritsar, Punjab, India
,
Ravinder Singh
Department of Gastrosciences, Fortis Escorts Hospital, Amritsar, Punjab, India
› Author Affiliations
Further Information

Publication History

Publication Date:
26 September 2019 (online)

  PDF Download Permissions and Reprints

Abstract

Perforation is an uncommon but serious complication during endoscopic retrograde cholangiopancreatography (ERCP). The incidence of perforation though small but is the one that requires immediate management. Delay in identifying this complication can lead to severe morbidity and even mortality in selected cases. If one can identify a perforation during the procedure (ERCP), then the minimally invasive technique such as clipping of the perforation in expert hands can save a lot of additional operative procedures and additional hospital stay costs. We present one such case of large perforation during precut sphincterotomy in a case of difficult cannulation. The perforation was identified and successfully treated by clipping the perforation during the procedure which leads to quick recovery and short hospital stay.

Key words

Clipping - endoscopic retrograde cholangiopancreatography - perforation - precut sphincterotomy
 

  • References

  • 1 Wu HM, Dixon E, May GR, Sutherland FR. Management of perforation after endoscopic retrograde cholangiopancreatography (ERCP): A population-based review. HPB (Oxford) 2006;8:393-9.
  • 2 Howard TJ, Tan T, Lehman GA, Sherman S, Madura JA, Fogel E, et al. Classification and management of perforations complicating endoscopic sphincterotomy. Surgery 1999;126:658-63.
  • 3 Christensen M, Matzen P, Schulze S, Rosenberg J. Complications of ERCP: A prospective study. Gastrointest Endosc 2004;60:721-31.
  • 4 Masci E, Toti G, Mariani A, Curioni S, Lomazzi A, Dinelli M, et al. Complications of diagnostic and therapeutic ERCP: A prospective multicenter study. Am J Gastroenterol 2001;96:417-23.
  • 5 Davee T, Garcia JA, Baron TH. Precut sphincterotomy for selective biliary duct cannulation during endoscopic retrograde cholangiopancreatography. Ann Gastroenterol 2012;25:291-302.
  • 6 Binmoeller KF, Grimm H, Soehendra N. Endoscopic closure of a perforation using metallic clips after snare excision of a gastric leiomyoma. Gastrointest Endosc 1993;39:172-4.
  • 7 Kaneko T, Akamatsu T, Shimodaira K, Ueno T, Gotoh A, Mukawa K, et al. Nonsurgical treatment of duodenal perforation by endoscopic repair using a clipping device. Gastrointest Endosc 1999;50:410-3.
  • 8 Seibert DG. Use of an endoscopic clipping device to repair a duodenal perforation. Endoscopy 2003;35:189.
  • 9 Mangiavillano B, Viaggi P, Masci E. Endoscopic closure of acute iatrogenic perforations during diagnostic and therapeutic endoscopy in the gastrointestinal tract using metallic clips: A literature review. J Dig Dis 2010;11:12-8.
  • 10 Baron TH, Gostout CJ, Herman L. Hemoclip repair of a sphincterotomy-induced duodenal perforation. Gastrointest Endosc 2000;52:566-68.