Three Cases of Successful Non-surgical Management for ERCP-related Periampullary Iatrogenic Perforations

Abstract

The primary diseases of the three cases of periampullary perforation associated with ERCP were left intrahepatic bile duct stone, extrahepatic cholangiocarcinoma, and benign intrahepatic bile duct stricture, all of which were normal anatomies. The causes of perforation were guidewire manipulation after precutting, exceeded sphicnteretomy, and cholangioscopy manipulation in the bile duct, respectively. In one case, the perforation was diagnosed immediately after ERCP, and in the other two cases, one day and two days after ERCP, respectively, and all of them could be treated non-surgically, which includes endoscopic naso-biliary drainage, biliary metal stent placement, percutaneous drainage, and endoscopic ultrasound-guided transmural drainage.