Eleven patients with retroperitoneal perforation complicating endoscopic management
of bile duct obstruction were seen over a seven-year period. In nine patients endoscopic
sphincterotomy or pre-cut papillotomy had been performed, but in two who had not undergone
sphincterotomy perforation occurred because of the penetration of a guide wire during
attempts to negotiate a malignant bile duct stricture. Eight out of eleven patients
remained asymptomatic, and all recovered with conservative management. Asymptomatic
retroperitoneal perforation can complicate therapeutic ERCP even when sphincterotomy
is not performed, but conservative management is usually effective if the complications
is recognized immediately.
ERCP - Endoscopicsphincterotomy - Perforation - Treatment
