Risk factors and prevention and treatment strategies for perforation caused by endoscopic retrograde cholangiopancreatography

LIU Jingjing, GUO Yarong, CHAI Bao

PDF(603 KB)
PDF(603 KB)
Journal of Clinical Hepatol ›› 2025, Vol. 41 ›› Issue (05) : 996-1000. DOI: 10.12449/JCH250529
Review

Risk factors and prevention and treatment strategies for perforation caused by endoscopic retrograde cholangiopancreatography

Author information +
History +

Abstract

Endoscopic retrograde cholangiopancreatography （ERCP），as an advanced endoscopic diagnostic and therapeutic technique，plays an important role in clinical practice. However，due to its complex operation and high technical requirements，it may lead to a series of severe complications，among which perforation is an important issue of concern. Perforation not only increases pain and treatment difficulty，but also threatens the life of patients. In order to guarantee good clinical outcomes，it is necessary to further improve the standard processes for the prediction，diagnosis，and management of perforation due to ERCP. This article discusses the risk factors，diagnostic methods，preventive measures，and treatment strategies for ERCP-related gastrointestinal perforation，in order to provide a reference for identifying high-risk populations and developing individualized treatment regimens in clinical practice.

Key words

Cholangiopancreatography，Endoscopic Retrograde / Perforation / Risk Factors

Cite this article

EndNote

Ris (Procite)

Bibtex

Download Citations
LIU Jingjing , GUO Yarong , CHAI Bao. Risk factors and prevention and treatment strategies for perforation caused by endoscopic retrograde cholangiopancreatography. Journal of Clinical Hepatol. 2025, 41(05): 996-1000 https://doi.org/10.12449/JCH250529

References

List( Publishing order | Descend order by publishing year | Descend order by cited within ) Chart analysis
[1]
MENG WB, LI X, LI ZS. Standardize the management of ERCP complications and accelerate the widespread popularization of ERCP in China[J]. Chin J Dig Surg, 2024, 23(1): 55-58. DOI: 10.3760/cma.j.cn115610-20231217-00257.
孟文勃, 李汛, 李兆申. 规范ERCP并发症管理推进我国ERCP蓬勃发展[J]. 中华消化外科杂志, 2024, 23(1): 55-58. DOI: 10.3760/cma.j.cn115610-20231217-00257.
本文引用 [1]
[2]
DONG H, ZHANG WG, LIU SZ, et al. Preliminary study of extraction for common bile duct stones under cholangioscopy[J/CD]. Chin J Gastrointestial Endoscopy (Electronic Editon), 2023, 10(2): 92-96. DOI: 10.3877/cma.j.issn.2095-7157.2023.02.003.
董浩, 张文刚, 刘圣圳, 等. 胆道镜直视下胆总管结石取出术的初步探索[J/CD]. 中华胃肠内镜电子杂志, 2023, 10(2): 92-96. DOI: 10.3877/cma.j.issn.2095-7157.2023.02.003.
本文引用 [1]
[3]
JOHNSON KD, PERISETTI A, THARIAN B, et al. Endoscopic retrograde cholangiopancreatography-related complications and their management strategies: A “scoping” literature review[J]. Dig Dis Sci, 2020, 65(2): 361-375. DOI: 10.1007/s10620-019-05970-3.
本文引用 [5]
[4]
DAHIYA DS, PINNAM BSM, CHANDAN S, et al. Clinical outcomes and predictors for 30-day readmissions of endoscopic retrograde cholangiopancreatography in the United States[J]. J Gastroenterol Hepatol, 2024, 39(1): 141-148. DOI: 10.1111/jgh.16362.
本文引用 [1]
[5]
DUMONCEAU JM, KAPRAL C, AABAKKEN L, et al. ERCP-related adverse events: European Society of Gastrointestinal Endoscopy (ESGE) Guideline[J]. Endoscopy, 2020, 52(2): 127-149. DOI: 10.1055/a-1075-4080.
本文引用 [3]
[6]
LANGERTH A, ISAKSSON B, KARLSON BM, et al. ERCP-related perforations: A population-based study of incidence, mortality, and risk factors[J]. Surg Endosc, 2020, 34(5): 1939-1947. DOI: 10.1007/s00464-019-06966-w.
本文引用 [2]
[7]
STAPFER M, SELBY RR, STAIN SC, et al. Management of duodenal perforation after endoscopic retrograde cholangiopancreatography and sphincterotomy[J]. Ann Surg, 2000, 232(2): 191-198. DOI: 10.1097/00000658-200008000-00007.
本文引用 [1]
[8]
WEISER R, PENCOVICH N, MLYNARSKY L, et al. Management of endoscopic retrograde cholangiopancreatography-related perforations: Experience of a tertiary center[J]. Surgery, 2017, 161(4): 920-929. DOI: 10.1016/j.surg.2016.10.029.
本文引用 [5]
[9]
JANG DK, KIM J, PAIK CN, et al. Endoscopic retrograde cholangio‑pancreatography-related adverse events in Korea: A nationwide assessment[J]. United European Gastroenterol J, 2022, 10(1): 73-79. DOI: 10.1002/ueg2.12186.
本文引用 [1]
[10]
SHIMIZU T, YOSHIOKA M, MATSUSHITA A, et al. Causes and management of endoscopic retrograde cholangiopancreatography-related perforation: A retrospective study[J]. J Nippon Med Sch, 2023, 90(4): 316-325. DOI: 10.1272/jnms.JNMS.2023_90-305.
[11]
ZHOU F, ZHAN XY, HU D, et al. Evaluation of ERCP-related perforation: A single-center retrospective study[J]. Gastroenterol Rep (Oxf), 2024, 12: goae044. DOI: 10.1093/gastro/goae044.
本文引用 [3]
[12]
KHOURY T, MARI A, SBEIT W. Endoscopic retrograde cholangiopancreatography related perforations: Is there plenty to discover?[J]. Minerva Gastroenterol (Torino), 2021, 67(3): 273-275. DOI: 10.23736/S2724-5985.20.02736-1.
本文引用 [2]
[13]
ÖZCAN Ö, ARIKAN S. Determining the risk factors of complications due to endoscopic retrograde cholangiopancreatography[J]. Cureus, 2024, 16(1): e51666. DOI: 10.7759/cureus.51666.
本文引用 [1]
[14]
KWAK N, YEOUN D, ARROYO-MERCADO F, et al. Outcomes and risk factors for ERCP-related complications in a predominantly black urban population[J]. BMJ Open Gastroenterol, 2020, 7(1): e000462. DOI: 10.1136/bmjgast-2020-000462.
本文引用 [1]
[15]
TAKANO S, FUKASAWA M, SHINDO H, et al. Risk factors for perforation during endoscopic retrograde cholangiopancreatography in post-reconstruction intestinal tract[J]. World J Clin Cases, 2019, 7(1): 10-18. DOI: 10.12998/wjcc.v7.i1.10.
本文引用 [1]
[16]
BOOT M, CHEW K, ARCHER J, et al. Iatrogenic duodenal diverticulum perforation: A systematic review[J]. ANZ J Surg, 2023, 93(5): 1322-1328. DOI: 10.1111/ans.18376.
本文引用 [1]
[17]
SHI D, GUO SH, BAO YS, et al. Diagnosis and management of type II endoscopic retrograde cholangiopancreatography-related perforations: A multicenter retrospective study[J]. BMC Gastroenterol, 2024, 24(1): 241. DOI: 10.1186/s12876-024-03335-3.
本文引用 [1]
[18]
AK Ç, AYKUT H, PALA EM, et al. Post-ERCP complication analysis of an experienced center[J]. Surg Laparosc Endosc Percutan Tech, 2022, 32(6): 707-713. DOI: 10.1097/SLE.0000000000001113.
本文引用 [1]
[19]
KUCHARSKI K, ADLER DG. Comparison of technical failures and patient-related adverse events associated with 3 widely used mechanical lithotripters for ERCP: Insights from the U.S. Food and Drug Administration Manufacturer and User Facility Device Experience database[J]. Gastrointest Endosc, 2022, 96(5): 796-800. DOI: 10.1016/j.gie.2022.06.012.
本文引用 [1]
[20]
TASAR P, KILICTURGAY SA. Early results of conservative and surgical approach in Endoscopic Retrograde Cholangiopancreatography (ERCP) Perforations Single center experience[J]. Ann Ital Chir, 2023, 94: 367-374.
本文引用 [1]
[21]
GUERRA F, GIULIANI G, COLETTA D, et al. Clinical outcomes of ERCP-related retroperitoneal perforations[J]. Hepatobiliary Pancreat Dis Int, 2017, 16(2): 160-163. DOI: 10.1016/s1499-3872(16)60106-6.
本文引用 [1]
[22]
ZHANG Y, WENG M, HE S, et al. Stapfer type I duodenal perforation after endoscopic retrograde cholangiopancreatography: A clinical analysis of 4 cases[J]. J Clin Hepatol, 2021, 37(6): 1413-1415. DOI: 10.3969/j.issn.1001-5256.2021.06.037.
张勇, 翁敏, 何胜, 等. 经内镜逆行胰胆管造影术后StapferⅠ型十二指肠穿孔4例临床分析[J]. 临床肝胆病杂志, 2021, 37(6): 1413-1415. DOI: 10.3969/j.issn.1001-5256.2021.06.037.
本文引用 [2]
[23]
DAHALE AS, SRIVASTAVA S, SALUJA SS, et al. Management of scope-induced type I duodenal perforations: Over-the-scope clip versus surgery[J]. Indian J Gastroenterol, 2021, 40(3): 287-294. DOI: 10.1007/s12664-021-01152-0.
本文引用 [1]
[24]
ZONG W, LI YL. A case of purse-string suture in the treatment of type I perforation in endoscopic retrograde cholangiopancreatography[J/OL]. Chin J Dig Med Imageology Electron Ed, 2021, 11(1): 41-42. DOI: 10.3877/cma.j.issn.2095-2015.2021.01.009.
宗伟, 李玉龙. 荷包缝合术治疗内镜逆行胰胆管造影术中Ⅰ型穿孔一例[J/OL]. 中华消化病与影像杂志(电子版), 2021, 11(1): 41-42. DOI: 10.3877/cma.j.issn.2095-2015.2021.01.009.
[25]
FUJITA A, TASHIMA T, TANISAKA Y, et al. Endoscopic closure using an over-the-scope clip for pancreatobiliary endoscopy-related large gastrointestinal perforation (with video)[J]. DEN Open, 2021, 2(1): e48. DOI: 10.1002/deo2.48.
本文引用 [1]
[26]
HYUN JJ, KOZAREK RA, IRANI SS. Endoscopic suturing of a large type I duodenal perforation[J]. VideoGIE, 2018, 4(2): 78-80. DOI: 10.1016/j.vgie.2018.04.008.
本文引用 [1]
[27]
PALMERI E, HINDRYCKX P. Lumen-apposing metal stent-induced perforation during endoscopic ultrasound-directed transgastric retrograde cholangiopancreaticography managed with an endoscopic suturing device[J]. Endoscopy, 2024, 56(S 01): E679-E680. DOI: 10.1055/a-2362-0806.
本文引用 [1]
[28]
LEE JM, RIM CB. Endoscopic band ligation in endoscopic retrograde cholangiopancreatography related duodenal perforation[J]. 2021, 77(3): 136-140. DOI: 10.4166/kjg.2020.164.
[29]
YANG HY, CHEN JH. Endoscopic fibrin sealant closure of duodenal perforation after endoscopic retrograde cholangiopancreatography[J]. World J Gastroenterol, 2015, 21(45): 12976-12980. DOI: 10.3748/wjg.v21.i45.12976.
本文引用 [1]
[30]
BOZBIYIK O, CETIN B, GUMUS T, et al. Fully covered self-expandable metal stent for intraprocedural or late-diagnosed Type-II endoscopic retrograde cholangiopancreatography-related perforations[J]. BMC Gastroenterol, 2022, 22(1): 385. DOI: 10.1186/s12876-022-02466-9.
本文引用 [1]
[31]
MOHAMMADI TOFIGH A, TAHMASBI H, IRANSHAHI M, et al. Cecal perforation induced by migrated biliary stent as a rare complication of ERCP: A case report and literature review[J]. Case Rep Surg, 2023, 2023: 9493333. DOI: 10.1155/2023/9493333.
本文引用 [1]
[32]
KHAN HMA, HUSSAIN A, KUMAR VCS, et al. Fixation of the proximal flange of a lumen-apposing metal stent using a through-the-scope endoscopic suturing system to prevent stent migration in single-session EUS-directed transgastric ERCP: A pilot study[J]. Gastrointest Endosc, 2024, 100(1): 132-135. DOI: 10.1016/j.gie.2024.02.013.
本文引用 [1]
[33]
ZHANG LY, BEJJANI M, GHANDOUR B, et al. Endoscopic through-the-scope suturing[J]. VideoGIE, 2021, 7(1): 46-51. DOI: 10.1016/j.vgie.2021.08.006.
本文引用 [1]
[34]
MCCARTHY CJ, BUTROS SR, DAWSON SL, et al. Image-guided percutaneous management of duodenal perforation following endoscopic retrograde cholangiopancreatography (ERCP): Assessment of efficacy and safety[J]. Clin Radiol, 2018, 73(3): 319. DOI: 10.1016/j.crad.2017.09.014.
本文引用 [1]
[35]
THEOPISTOS V, THEOCHARIS G, KONSTANTAKIS C, et al. Non-operative management of type 2 ERCP-related retroperitoneal duodenal perforations: A 9-year experience from a single center[J]. Gastroenterology Res, 2018, 11(3): 207-212. DOI: 10.14740/gr1007w.
本文引用 [1]
[36]
YURTTAS C, THIEL C, WICHMANN D, et al. Retrospective analysis of different therapeutic approaches for retroperitoneal duodenal perforations[J]. Sci Rep, 2022, 12(1): 10243. DOI: 10.1038/s41598-022-14278-8.
本文引用 [1]
[37]
CIROCCHI R, KELLY MD, GRIFFITHS EA, et al. A systematic review of the management and outcome of ERCP related duodenal perforations using a standardized classification system[J]. Surgeon, 2017, 15(6): 379-387. DOI: 10.1016/j.surge.2017.05.004.
本文引用 [1]
[38]
KUMBHARI V, SINHA A, REDDY A, et al. Algorithm for the management of ERCP-related perforations[J]. Gastrointest Endosc, 2016, 83(5): 934-943. DOI: 10.1016/j.gie.2015.09.039.
本文引用 [1]
[39]
YEH TC. Laparoscopic resection of perforated duodenal diverticulum - A case report and literature review[J]. Int J Surg Case Rep, 2016, 28: 204-210. DOI: 10.1016/j.ijscr.2016.10.001.
本文引用 [1]
[40]
JOHNSON G, WEBSTER G, BOŠKOSKI I, et al. Curriculum for ERCP and endoscopic ultrasound training in Europe: European Society of Gastrointestinal Endoscopy (ESGE) Position Statement[J]. Endoscopy, 2021, 53(10): 1071-1087. DOI: 10.1055/a-1537-8999.
本文引用 [1]

刘晶晶负责课题设计，搜集文献并分析，撰写论文；郭亚荣负责指导论文写作及修改论文；柴宝负责指导论文写作及最后定稿。

Funding

Natural Science Foundation of Shanxi Province(202303021221220)

Comments

PDF(603 KB)

Accesses

Citation

Detail
Sections
Recommended
Copyright © Journal of Clinical Hepatol, All Rights Reserved.
Powered by Beijing Magtech Co. Ltd.

/

〈 〉