Publication | Open Access
Closure with an over-the-scope clip allows therapeutic ERCP to be safely performed after acute duodenal perforation during diagnostic endoscopic ultrasound
12
Citations
0
References
2013
Year
Minimally Invasive ProcedureEndoscopic Retrograde CholangiographyGastroenterologySurgeryEndoscopic ImagingDiagnostic EusRadiologyTherapeutic ErcpOver-the-scope ClipGi TechniqueUltrasoundDuodenal PerforationEndoscopic DiagnosisAcute Duodenal PerforationInterventional Endoscopic UltrasoundGastrointestinal PathologyInterventional EndoscopyMedicineAnesthesiology
The use of endoscopic ultrasound (EUS) before endoscopic retrograde cholangiography (ERC), if performed, can prevent two-thirds of unnecessary ERC procedures [1]. Duodenal perforation during diagnostic EUS occurs with an incidence of less than 1 % [2]. When perforation does occur, surgical or conservative management is possible. Surgery permits simultaneous treatment of the perforation and any biliary pathology if present [3]. Conservative management has been described using closure by endoscopic clipping [4]. Endoscopic retrograde cholangiopancreatography (ERCP) is then postponed, so avoiding duodenal maneuver and insufflation that could damage endoscopically placed sutures or aggravate the clinical picture. The over-the-scope clip (OTSC; Ovesco Endoscopy GmbH, Tübingen, Germany) is a new full-thickness clipping device that has been used successfully to treat gastrointestinal perforation [5].