Retroperitoneal perforation during duodenoscopic sphincterotomy

Perforation into the retroperitoneal space may occur during duodenoscopic sphincterotomy and can be recognized radiographically. While it is potentially serious, most patients should respond to conservative management provided that adequate biliary drainage is achieved. Five cases encountered during approximately 500 sphincterotomies are presented. Radiographs taken 24 hours after 50 additional procedures showed no evidence of perforation.