Surgical intervention of severe post-ERCP-pancreatitis accompanied with duodenum perforation.
Endoscopic retrograde cholangiopancreatography (ERCP) is a procedure widely used to diagnose and treat conditions of biliary or pancreatic ductal system. The post-ERCP severe acute pancreatitis (SAP) accompanied with duodenum perforation is rare but serious, remaining a challenge in clinic. In this study we report two such cases. Two Chinese women were treated for clinical suspicion of bile duct obstruction and underwent ERCP after admission. Both developed duodenum perforation and SAP after ERCP, and were managed in the intensive care unit (ICU) and required an organ-failure support. The surgical intervention of the peri-pancreatic debridement with lumber-abdominal compound incisions and postoperative washing and drainage was performed, and the two patients recovered well. The therapeutic effect of the peri-pancreatic debridement with lumber-abdominal compound incisions combined with postoperative washing and drainage in the patients of severe post-ERCP-pancreatitis (PEP) and duodenum perforation is satisfactory.
Chen
Zuo-bing
ZB
Department of Emergency Surgery, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, China. bigzyun1@sina.com
Liang
Zhong-yan
ZY
Zhang
Yun
Y
Zhang
Shao-yang
SY
Zheng
Shu-sen
SS
D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000009:adverse effects*; D002779:Cholestasis / Q000175:diagnosis; D003422:Critical Care; D004322:Drainage / Q000379:methods; D004386:Duodenum / Q000293:injuries* / Q000601:surgery*; D005260:Female; D006801:Humans; D008875:Middle Aged; D010183:Pancreatic Ducts / Q000601:surgery; D010195:Pancreatitis / Q000209:etiology* / Q000601:surgery*; D011183:Postoperative Complications; D016896:Treatment Outcome