Emergent Endoscopic Retrograde Cholangiopancreatography with Placement of Biliary Double Stents to Salvage Endoscopic Retrograde Cholangiopancreatography-lnduced Stapfer＇s Type Ⅱ Perforation

作     者：Ping Yue Wen-Bo Meng Joseph W Leung Lei Zhang Xiao-Liang Zhu Hui Zhang Hai-Ping Wang Zheng-Feng Wang Ke-Xiang Zhu Long Miao Wen-Ce Zhou Xun Li Yue Ping;Meng Wen-Bo;Leung Joseph W;Zhang Lei;Zhu Xiao-Liang;Zhang Hui;Wang Hai-Ping;Wang Zheng-Feng;Zhu Ke-Xiang;Miao Long;Zhou Wen-Ce;Li Xun

作者机构：Department of Special Minimally Invasive Surgery The First Hospital of Lanzhou University Lanzhou Gansu 730000 China Division of Gastroenterology and Hepatology UC Davis Medical Center Sacramento CA 95816 USA The Fifth Department of General Surgery The First Hospital of Lanzhou University Lanzhou Gansu 730000 China The Second Department of General Surgery The First Hospital of Lanzhou University Lanzhou Gansu 730000 China Key Laboratory of Biological Therapy and Regenerative Medicine Transformation Gansu Province Lanzhou Gansu 730000 China 

出 版 物：《Chinese Medical Journal》 (中华医学杂志（英文版）)

年 卷 期：2018年第131卷第19期

页      面：2346-2348页

核心收录：

学科分类：1007[医学-药学(可授医学、理学学位)] 100705[医学-微生物与生化药学] 082903[工学-林产化学加工工程] 08[工学] 0829[工学-林业工程] 10[医学] 

基　　金：This study was supported by grants from the National Natural Science Fund of China (No. 31570509)  CAS "Light of West China" Program (No. 90  2015)  and Gansu Province Science Foundation for Youths (No. 17JR5RA259) 

摘      要：To the Editor：Endoscopic retrograde cholangiopancreatography （ERCP） plays a vital role in the management ofpancreaticobiliary diseases in recent years and it concomitantly carries a risk of complications including post-ERCP pancreatitis,cholangitis,bleeding,and *** incidence of primary post-ERCP complications ranges from 5.4% to 23.0%,and ERCP-induced perforation can occur in 0.3-1.0% of cases,but the associated mortality is high ranging from 8% to 23%.[1] Because of the confluence of the bile duct and pancreatic duct meet at the papilla in proximity to the site of perforation in the duodenum,there is a potential risk of leakage of bile and pancreatic juice into the retroperitoneal space or *** with Stapfer＇s Type Ⅱ perforation （perivaterian perforation） generally suffered from systemic inflammatory response syndrome,which could progress rapidly to acute lung injury and acute renal insufficiency and even multiple organ *** of these contribute to the significantly high mortality.A timely recognition and appropriate treatment are crucial to the management of ERCP-induced perforation to reduce the overall ***,surgery remains the primary treatment for iatrogenic *** the improvement in endoscopic technique and development of new accessories,nonsurgical management with endoscopic treatment of perforation is increasingly being reported.[2] We report a retrospective analysis of ERCP-induced Stapfer＇s Type Ⅱ perforations over a 5-year period managed with nonsurgical approach combined with salvage ERCP.