title: ERCP-related perforations in the new millennium: A large tertiary referral center 10-year experience.
abstract: BACKGROUND
  Endoscopic retrograde cholangiopancreatography (ERCP) is an important diagnostic and therapeutic modality for pancreatic and biliary disorders. Perforation is one of the most dreaded complications of ERCP. Since it is uncommon, there has been little study of incidence, risk factors, and outcomes of management.
  
  
  OBJECTIVE
  We aim to assess the incidence of ERCP-related perforations and outcomes at a large tertiary referral center.
  
  
  METHODS
  We undertook a review of an ERCP database for all perforations from 2002 to December 2012.
  
  
  RESULTS
  The cumulative incidence of ERCP-related perforations was 0.14% (12 out of 8264), and sphincterotomy-related perforations constituted the most common cause. The mean age of these 12 patients was 58.6 years and majority were female (83.3%). The most common indications for ERCP were: suspected sphincter of Oddi dysfunction (SOD) 41%, and common bile duct stones (CBD stones) 41%. Nine of the 12 patients (75%) had a leak and were managed medically, and four who had a perforation had surgical repair (25%).
  
  
  CONCLUSIONS
  In our study, leaks were much more common than perforations and the majority of patients were successfully managed with conservative therapy alone. We report a very low perforation rate and most perforations can be managed conservatively with a good outcome.
authors: Division of Gastroenterology and Hepatology, Basil I. Hirschowitz Endoscopic Center of Excellence, University of Alabama at Birmingham, Alabama, USA.
authors: Sudha
authors: S
authors: Kodali
authors: Division of Gastroenterology and Hepatology, Basil I. Hirschowitz Endoscopic Center of Excellence, University of Alabama at Birmingham, Alabama, USA.
authors: Klaus
authors: K
authors: Mönkemüller
authors: Division of Gastroenterology and Hepatology, Basil I. Hirschowitz Endoscopic Center of Excellence, University of Alabama at Birmingham, Alabama, USA.
authors: Hwasoon
authors: H
authors: Kim
authors: Division of Gastroenterology and Hepatology, Basil I. Hirschowitz Endoscopic Center of Excellence, University of Alabama at Birmingham, Alabama, USA.
authors: Jayapal
authors: J
authors: Ramesh
authors: Division of Gastroenterology and Hepatology, Basil I. Hirschowitz Endoscopic Center of Excellence, University of Alabama at Birmingham, Alabama, USA.
authors: Jessica
authors: J
authors: Trevino
authors: Division of Gastroenterology and Hepatology, Basil I. Hirschowitz Endoscopic Center of Excellence, University of Alabama at Birmingham, Alabama, USA.
authors: Shyam
authors: S
authors: Varadarajulu
authors: Division of Gastroenterology and Hepatology, Basil I. Hirschowitz Endoscopic Center of Excellence, University of Alabama at Birmingham, Alabama, USA.
authors: C Mel
authors: CM
authors: Wilcox
keywords: ERCP complication; ERCP leak; ERCP perforation; ERCP perforation management
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