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[Therapeutic results after papilloduodenal injuries following ERCP]
F Thermann1, E Lotterer, J Ukkat
1Klinik für Allgemein-, Viszeral- und Gefässchirurgie, Universitätsklinikum Halle.
Introduction:
Our goal was to compare operative vs. conservative therapeutic strategies after injuries following ERCP.
Methods:
Eight patients with ERCP-induced injuries were surveyed retrospectively. Four of them were treated operatively, four conservatively. Criteria for an operative therapy were clinical and radiological findings and laboratory data.
Results:
The four patients that were treated conservatively had an uncomplicated course whereas three of four patients treated operatively had long and complicated stays. In these patients the operation was performed more than 24 hours after injury. All of them showed advanced biliary peritonitis. One patient was operated on within 24 hours. He was discharged after a short stay without complications. All injuries were located in the retroperitoneum. Five patients showed anatomical abnormality of either duodenum, papilla or common bile duct. In five cases the duodenum was involved in the injury.
Conclusions:
The course of disease of the operated patients was longer and more complicated compared to those treated conservatively. According to our data the timing of the operation seems to be an important criterion with respect to the prognosis. Due to the small number of patients, whether conservative therapy should be preferred cannot be determined. The role of the location of injury is also not clarified.