Analysis of operative treatment of endoscopic retrograde cholangiopancreatography-related duodenal perforation

Objective To analyze operative outcomes of endoscopic retrograde cholangiopancreatography (ERCP) rela-ted duodenal perforations. Methods Retrospective analysis was performed with the clinical data of 14 patients who had duodenal perforation during ERCP including 13 cases in Ruijin Hospital and one c...

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Main Author: CHEN Sheng, LI Qianyi, LI Nengping, WU Weize
Format: Article
Language:zho
Published: Editorial Office of Journal of Surgery Concepts & Practice 2020-07-01
Series:Waike lilun yu shijian
Subjects:
Online Access:https://www.qk.sjtu.edu.cn/jscp/fileup/1007-9610/PDF/1658114160997-1115105773.pdf
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author CHEN Sheng, LI Qianyi, LI Nengping, WU Weize
author_facet CHEN Sheng, LI Qianyi, LI Nengping, WU Weize
author_sort CHEN Sheng, LI Qianyi, LI Nengping, WU Weize
collection DOAJ
description Objective To analyze operative outcomes of endoscopic retrograde cholangiopancreatography (ERCP) rela-ted duodenal perforations. Methods Retrospective analysis was performed with the clinical data of 14 patients who had duodenal perforation during ERCP including 13 cases in Ruijin Hospital and one case in Ruijin Hospital North from Ja-nuary 2011 to May 2014. Surgical timing and procedure were analyzed. Duodenal perforations were classified into types according to Stapfer. Results There were type Ⅰ lesions in 2 cases, type Ⅱ lesions in 10 cases,and type Ⅲ lesions in 2 cases. The time to operation was during ERCP of type Ⅰ injuries, (2.0±1.1) (0-5.0) d of type Ⅱ injuries, and (6.0±2.8) (4.0-8.0) d of type Ⅲ injuries after ERCP with significant statistical difference (P<0.05), indicating different progress to abdominal infection from type Ⅰ, type Ⅱ, and type Ⅲ perforation. There were 3 cases of type Ⅱ perforation who had operation of duodenal diverticulation with two cases cured and one case died. No significant difference was present in hospital stay and mortality of the patients of type Ⅱ between 3 cases treated by duodenal diverticulation and 7 cases without duodenal diverticulation (P=0.451,P=0.300). Hospital stay of type Ⅰ, type Ⅱ, type Ⅲ was (49.0±32.5) d, (81.6±30.0) d, (51.0±22.6) d respectively without significant difference (P=0.239). Two cases 80 year and 86 year died had ampullary cancer, who were elder than cured cases (60~76) y with significant statistical difference (P<0.05). Conclusions Operation remains an important treatment for ERCP-related duodenal perforation. Optimal operation based on the type of ERCP related perforation and abdominal infection could be the key to affect efficacy. Elder patients with malignant tumor have poorer prognosis.
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spelling doaj.art-14021050edea4e7b8a64d54d62288b692023-10-27T02:09:35ZzhoEditorial Office of Journal of Surgery Concepts & PracticeWaike lilun yu shijian1007-96102020-07-01250431131410.16139/j.1007-9610.2020.04.009Analysis of operative treatment of endoscopic retrograde cholangiopancreatography-related duodenal perforationCHEN Sheng, LI Qianyi, LI Nengping, WU Weize01. Department of Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China;2. Department of Surgery, Ruijin Hospital North, Shanghai Jiao Tong University School of Medicine, Shanghai 201821, ChinaObjective To analyze operative outcomes of endoscopic retrograde cholangiopancreatography (ERCP) rela-ted duodenal perforations. Methods Retrospective analysis was performed with the clinical data of 14 patients who had duodenal perforation during ERCP including 13 cases in Ruijin Hospital and one case in Ruijin Hospital North from Ja-nuary 2011 to May 2014. Surgical timing and procedure were analyzed. Duodenal perforations were classified into types according to Stapfer. Results There were type Ⅰ lesions in 2 cases, type Ⅱ lesions in 10 cases,and type Ⅲ lesions in 2 cases. The time to operation was during ERCP of type Ⅰ injuries, (2.0±1.1) (0-5.0) d of type Ⅱ injuries, and (6.0±2.8) (4.0-8.0) d of type Ⅲ injuries after ERCP with significant statistical difference (P<0.05), indicating different progress to abdominal infection from type Ⅰ, type Ⅱ, and type Ⅲ perforation. There were 3 cases of type Ⅱ perforation who had operation of duodenal diverticulation with two cases cured and one case died. No significant difference was present in hospital stay and mortality of the patients of type Ⅱ between 3 cases treated by duodenal diverticulation and 7 cases without duodenal diverticulation (P=0.451,P=0.300). Hospital stay of type Ⅰ, type Ⅱ, type Ⅲ was (49.0±32.5) d, (81.6±30.0) d, (51.0±22.6) d respectively without significant difference (P=0.239). Two cases 80 year and 86 year died had ampullary cancer, who were elder than cured cases (60~76) y with significant statistical difference (P<0.05). Conclusions Operation remains an important treatment for ERCP-related duodenal perforation. Optimal operation based on the type of ERCP related perforation and abdominal infection could be the key to affect efficacy. Elder patients with malignant tumor have poorer prognosis.https://www.qk.sjtu.edu.cn/jscp/fileup/1007-9610/PDF/1658114160997-1115105773.pdf|endoscopic retrograde cholangiopancreatography|duodenal perforation|operation
spellingShingle CHEN Sheng, LI Qianyi, LI Nengping, WU Weize
Analysis of operative treatment of endoscopic retrograde cholangiopancreatography-related duodenal perforation
Waike lilun yu shijian
|endoscopic retrograde cholangiopancreatography|duodenal perforation|operation
title Analysis of operative treatment of endoscopic retrograde cholangiopancreatography-related duodenal perforation
title_full Analysis of operative treatment of endoscopic retrograde cholangiopancreatography-related duodenal perforation
title_fullStr Analysis of operative treatment of endoscopic retrograde cholangiopancreatography-related duodenal perforation
title_full_unstemmed Analysis of operative treatment of endoscopic retrograde cholangiopancreatography-related duodenal perforation
title_short Analysis of operative treatment of endoscopic retrograde cholangiopancreatography-related duodenal perforation
title_sort analysis of operative treatment of endoscopic retrograde cholangiopancreatography related duodenal perforation
topic |endoscopic retrograde cholangiopancreatography|duodenal perforation|operation
url https://www.qk.sjtu.edu.cn/jscp/fileup/1007-9610/PDF/1658114160997-1115105773.pdf
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