Treating of duodenal perforation following endoscopic retrograde transpapillary manipulations

Abstract

Objective: valuation of diff erent duodenal perforation surgical management following endoscopic retrograde transpapillary manipulations. Materials and methods: thirty-one patients with duodenal perforation following transpapillary manipulations (17 own observations, 14 — admission from other hospitals). Th e 14 (45.2 %) cases had a diagnosis less than 24 hours, 17 (54.8 %) — more than 24 hours aft er injury. Twenty patients had the primary reconstruction of duodenum with various drainage options of zone of injury. Sixteen patients had a two-stage surgery procedure: 5 cases aft er of primary reconstruction of duodenum and 11 — like a primary surgery (more than a day aft er injury). Results: aft er primary of duodenum reconstruction 11 patients (55.0 %) had no complications, 5 (25.0 %) — were re-operated, 4 (20.0 %) — were died. Aft er two-stage surgery procedure 9 patients (56.3 %) had no complications, fi ve (31.2 %) had surgical complications, 2 (12.5 %) were died. Conclusion: the primary of duodenum reconstruction can be performing, when the duodenal perforation there is less than a day. When there is a clinic of septic complication of retroperitoneum and abdominal cavity, two-stage surgery procedure is justifi ed.