Post written by Tomoya Emori, MD, PhD, from Wakayama Rosai Hospital, Wakayama, Japan.

This study retrospectively evaluated the characteristics and clinical outcomes of patients with ERCP-related duodenal perforations according to the mechanism of injury.

Perforation is a rare but serious adverse event associated with ERCP. There is no consensus to guide clinicians in the management of ERCP-related duodenal perforations, making it difficult to determine whether surgical or endoscopic treatment is optimal.

Our results provided 2 new pieces of knowledge. First, diagnosing a perforation during the ERCP procedure can prevent serious adverse events. Fluoroscopic and endoscopic images should be carefully reviewed. Second, endoscopic management should be the treatment of choice for patients diagnosed with perforation during ERCP procedures.

In the future, a study comparing different endoscopic treatment methods for ERCP-related duodenal perforations in a larger number of hospitals and patients would lead to development of an algorithm that selects the most effective endoscopic treatment method.

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