Clinical analysis of risk factors for ERCP-related perforation

Objective To evaluate the causes, diagnostic and therapeutic principles, and prevention of the perforation related to endoscopic retrograde cholangiopancreatography (ERCP) . Methods All patients who developed perforation after ERCP in the Central Hospital of Shanghai Jiading District from January 2009 to December 2013 were recruited. The causes, types, and diagnosis and treatment of perforation were analyzed retrospectively. Results ERCP was done in 459 cases during the 4 years, and 6 (1. 3%) of them developed perforation.The causes of perforation were as follows: endoscope insertion (3 cases) , catheterization or sphincterotomy (2 cases) , and guide wire or Dormia basket (1 case) . Two cases received conservative management successfully and were discharged; four cases underwent surgical treatment, and one of them died. Conclusion Patients with ERCP-related perforation can achieve ideal prognosis through individualized treatment based on the causes and types of perforation. Careful and cautious operation, especially for the elderly or the patients with a history of upper abdominal operation, will reduce the incidence of ERCP-related perforation.