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  Vol. 142 No. 11, November 2007 TABLE OF CONTENTS
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Validity of Clinical Criteria in the Management of Endoscopic Retrograde Cholangiopancreatography–Related Duodenal Perforations—Invited Critique

Henry A. Pitt, MD

Arch Surg. 2007;142(11):1065.

Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

Assalia and colleagues described 22 patients with ERCP-related DPs in a series of 3104 procedures (0.7%) performed during a 71/2-year period. Clinical and radiologic criteria were developed and were applied preoperatively to guide management. Early diagnosis was established in 20 patients (91%). Twenty patients (91%) were initially treated nonoperatively, whereas 2 with scope-related lateral duodenal intraperitoneal perforations were treated successfully with early surgery. Two additional patients underwent late salvage surgery, and 1 of these patients eventually died of sepsis. Three patients were treated endoscopically using an indwelling (n = 2) or a nasobiliary (n = 1) stent. One patient was treated with a percutaneous biliary stent. Thus, 14 patients (64%) were treated without a surgical, endoscopic, or percutaneous procedure, although 5 of these patients underwent a second therapeutic endoscopic procedure 7 to 14 days after the perforation.

In treating patients with a DP after ERCP, multiple factors must be . . . [Full Text of this Article]


AUTHOR INFORMATION

RELATED ARTICLE

Validity of Clinical Criteria in the Management of Endoscopic Retrograde Cholangiopancreatography–Related Duodenal Perforations
Ahmad Assalia, Alain Suissa, Anat Ilivitzki, Ahmad Mahajna, Kamal Yassin, Moshe Hashmonai, and Michael Moshe Krausz
Arch Surg. 2007;142(11):1059-1064.
ABSTRACT | FULL TEXT  






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