Value of temporary stents for the management of perivaterian perforation during endoscopic retrograde cholangiopancreatography

Table 1 Classification of endoscopic retrograde cholangiopancreatography-related perforations

Ref.	Type
Stapfer et al[18]	Type I, duodenal perforation of medial or lateral wall
	Type II, perivaterian perforation
	Type III, perforation of distal bile duct
	Type IV, retroperitoneal air alone
Howard et al[17]	Group I, guidewire perforation
	Group II, periampullary retroperitoneal perforation
	Group III, duodenal perforation remote from the ampulla

Table 2 Treatment of periampullary perforations (Stapfer’s type II perforations)

Ref.	Patients (n)	Patients according to treatment method, n (%)	Treatment method	Mortality n (%)
Alfieri et al[15]	15	6 (40.0)	Conservative management + ENBD ± PTBD	0 (0.0)
		9 (60.0)	Surgery	1 (11.1)
Wu et al[16]	11	6 (54.5)	Conservative management	0 (0.0)
		5 (45.5)	Surgery	4 (80.0)
Kim et al[58]	5	2 (40.0)	Conservative management	0 (0.0)
		3 (60.0)	Surgery	0 (0.0)
Enns et al[12]	13	11 (84.6)	Conservative management ± biliary drainage (PTBD, ERBD)	0 (0.0)
		2 (13.4)	Surgery	0 (0.0)
Polydorou et al[23]	30	24 (80.0)	Conservative management ± biliary drainage (PTBD, ERBD)	0 (0.0)
		6 (20.0)	Surgery	0 (0.0)
Stapfer et al[18]	6	3 (50.0)	Conservative management	0 (0.0)
		3 (50.0)	Surgery	0 (0.0)
Howard et al[17]	22	18 (81.8)	Conservative management ± biliary drainage (ENBD, ERBD)	0 (0.0)
		4 (18.2)	Surgery	1 (25)
Morgan et al[22]	12	12 (100.0)	Conservative management	0 (0.0)
		0 (0.0)	Surgery	0 (0.0)
Kim et al[59]	9	8 (88.8)	Conservative management ± ENBD	0 (0.0)
		1 (11.2)	Surgery	0 (0.0)

Conservative management: intravenous antibiotics, fluids, pain control, nil-by-mouth, close monitoring, and nasogastric drainage. ENBD: Endoscopic nasobiliary drainage; PTBD: Percutaneous transhepatic biliary drainage; ERBD: Endoscopic retrograde biliary drainage.

Table 3 Temporary self-expandable metallic stent used for peri-ampullary perforations

Ref.	Age/sex	ERCP indication	Abdominal CT scan	Stent indication	Type of stent/duration (d)
Vezakis et al[28]	61/F	Stones or sphincter of Oddi dysfunction	Retroperitoneal air	Duodenal fistula, Continuing leakage	Partially covered SEMS/14
Jeon et al[26]	82/F	Stones	Retroperitoneal air and fluid	Continuing leakage	Fully covered SEMS/28
Canena et al[25]	55/F	Stones	Retroperitoneal air and fluid	Perforation	Fully covered SEMS/21
	29/F	Stones	Retroperitoneal air and fluid	Perforation	Fully covered SEMS/30
	31/M	Stones	Retroperitoneal air and fluid	Perforation	Fully covered SEMS/30
	76/F	Stones	Retroperitoneal air and fluid	Perforation	Fully covered SEMS/29
Park et al[27]	61/F	Biliary tree dilatation	Retroperitoneal air and fluid	Perforation	Fully covered SEMS/10
Unpublished	46/M	Stones	Retroperitoneal air	Perforation	Fully covered SEMS/ spontaneously fell out

CT: Computed tomography; SEMS: Self-expandable metallic stent; ERCP: Endoscopic retrograde cholangiopancreatography.