title: [Duodenal perforations after endoscopic retrograde cholangiopancreatography].
abstract: BACKGROUND
  Duodenal perforations after endoscopic retrograde cholangiopancreatography (ERCP) are an uncommon complication. The management of this kind of perforation is controversial. The aim of this study was to analyze the results of the management of a series of 15 patients who were diagnosed with this complication.
  
  
  METHODS
  Retrospective study of duodenal perforations after ERCP diagnosed at a tertiary level hospital, between 2001 and 2011. The variables age, sex, ERCP indication, type of perforation, time of diagnosis, clinical presentation, radiographic findings, management, surgical technique, length of stay and intrahospital mortality were recorded and analyzed.
  
  
  RESULTS
  Out of a total of 1923 ERCP performed, 15 duodenal perforations were detected (0,78%). Perforation site was the duodenal wall (3 cases) and periampullary (12 cases). Eleven perforations were suspected during the procedure. Patients with duodenal wall perforations underwent immediate surgery. Seven of 12 periampullary perforations were managed conservatively with a favorable outcome in 5 of them. Subsequent scheduled surgery was performed in 4 cases. The mean length of hospital stay was 21,2 days (range: 3-49) and intra-hospital mortality was 20%.
  
  
  CONCLUSIONS
  Perforations after ERCP have high mortality rates, and require a complicated therapeutic approach that needs to be individualized. Selective conservative management is a valid and safe option in selected patients.
authors.affiliation: Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario de Gran Canaria Doctor Negrín, Las Palmas de Gran Canaria, España. Electronic address: mdesi_83@hotmail.com.
authors.forename: María Desirée
authors.initials: MD
authors.lastname: Armas Ojeda
authors.affiliation: Servicio de Digestivo, Hospital Universitario de Gran Canaria Doctor Negrín, Las Palmas de Gran Canaria, España.
authors.forename: Vanesa
authors.initials: V
authors.lastname: Ojeda Marrero
authors.affiliation: Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario de Gran Canaria Doctor Negrín, Las Palmas de Gran Canaria, España.
authors.forename: Cristina
authors.initials: C
authors.lastname: Roque Castellano
authors.affiliation: Servicio de Digestivo, Hospital Universitario de Gran Canaria Doctor Negrín, Las Palmas de Gran Canaria, España.
authors.forename: José Carlos
authors.initials: JC
authors.lastname: Cabrera Marrero
authors.affiliation: Servicio de Digestivo, Hospital Universitario de Gran Canaria Doctor Negrín, Las Palmas de Gran Canaria, España.
authors.forename: María Del Pino
authors.initials: Mdel P
authors.lastname: Mathías Gutierrez
authors.affiliation: Servicio de Digestivo, Hospital Universitario de Gran Canaria Doctor Negrín, Las Palmas de Gran Canaria, España.
authors.forename: Daniel
authors.initials: D
authors.lastname: Ceballos Santos
authors.affiliation: Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario de Gran Canaria Doctor Negrín, Las Palmas de Gran Canaria, España.
authors.forename: Joaquín
authors.initials: J
authors.lastname: Marchena Gómez
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000009:adverse effects*; D004386:Duodenum / Q000293:injuries*; D005260:Female; D006801:Humans; D007416:Intestinal Perforation / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D055815:Young Adult
keywords: Colangiografía retrógrada endoscópica; Complicaciones; Complications; Endoscopic retrograde cholangiopancreatography; Perforación; Perforation