[Surgical management of severe hemorrhage and retroperitoneal perforation after endoscopic sphincterotomy]

From 1990 to 1993, 5 patients with severe hemorrhage and retroperitoneal perforation following endoscopic sphincterotomy (EST) were surgically treated. Two patients with hemorrhage and one with perforation survived. The remaining two died of hemorrhage plus perforation. Early diagnosis and surgical intervention was very important to lower the mortality, especially in those with common bile duct stones retention, acute pancreatitis, or cholangitis. For patients with late stage perforation or recurrent hemorrhage, palliative procedure aimed at isolating the EST incision from the digestion of bile and pancreatic juice should be performed.