Endoscopy 2014; 46(08): 693-711
DOI: 10.1055/s-0034-1377531
Guideline
© Georg Thieme Verlag KG Stuttgart · New York

Diagnosis and management of iatrogenic endoscopic perforations: European Society of Gastrointestinal Endoscopy (ESGE) Position Statement

Gregorios A. Paspatis
1   Gastroenterology Department, Benizelion General Hospital, Heraklion, Crete, Greece
,
Jean-Marc Dumonceau
2   Gedyt Endoscopy Center, Buenos Aires, Argentina
,
Marc Barthet
3   LBA UMR T24, Faculty of Medicine, Aix-Marseille University, Marseille, France
,
Søren Meisner
4   Endoscopy Unit, Digestive Disease Center, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark
,
Alessandro Repici
5   Department of Gastroenterology, Digestive Endoscopy Unit, IRCCS Istituto Clinico Humanitas, Milan, Italy
,
Brian P. Saunders
6   Wolfson Unit for Endoscopy, St Mark’s Hospital & Imperial College, London, UK
,
Antonios Vezakis
7   Second Department of Surgery, Aretaieion University Hospital, Athens, Greece
,
Jean Michel Gonzalez
3   LBA UMR T24, Faculty of Medicine, Aix-Marseille University, Marseille, France
,
Stine Ydegaard Turino
4   Endoscopy Unit, Digestive Disease Center, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark
,
Zacharias P. Tsiamoulos
6   Wolfson Unit for Endoscopy, St Mark’s Hospital & Imperial College, London, UK
,
Paul Fockens
8   Department of Gastroenterology and Hepatology, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
,
Cesare Hassan
9   Digestive Endoscopy Unit, Catholic University, Rome, Italy
› Institutsangaben
Weitere Informationen

Publikationsverlauf

Publikationsdatum:
21. Juli 2014 (online)

This Position Paper is an official statement of the European Society of Gastrointestinal Endoscopy (ESGE). It addresses the diagnosis and management of iatrogenic perforation occurring during diagnostic or therapeutic digestive endoscopic procedures.

Main recommendations

1 ESGE recommends that each center implements a written policy regarding the management of iatrogenic perforation, including the definition of procedures that carry a high risk of this complication. This policy should be shared with the radiologists and surgeons at each center.

2 In the case of an endoscopically identified perforation, ESGE recommends that the endoscopist reports: its size and location with a picture; endoscopic treatment that might have been possible; whether carbon dioxide or air was used for insufflation; and the standard report information.

3 ESGE recommends that symptoms or signs suggestive of iatrogenic perforation after an endoscopic procedure should be carefully evaluated and documented, possibly with a computed tomography (CT) scan, in order to prevent any diagnostic delay.

4 ESGE recommends that endoscopic closure should be considered depending on the type of perforation, its size, and the endoscopist expertise available at the center. A switch to carbon dioxide insufflation, the diversion of luminal content, and decompression of tension pneumoperitoneum or tension pneumothorax should also be done.

5 After closure of an iatrogenic perforation using an endoscopic method, ESGE recommends that further management should be based on the estimated success of the endoscopic closure and on the general clinical condition of the patient. In the case of no or failed endoscopic closure of the iatrogenic perforation, and in patients whose clinical condition is deteriorating, hospitalization and surgical consultation are recommended.

 
  • References

  • 1 Bielawska B, Day AG, Lieberman DA et al. Risk factors for early colonoscopic perforation include non-gastroenterologist endoscopists: a multivariable analysis. Clin Gastroenterol Hepatol 2014 2014; 12: 85-92
  • 2 Voermans RP, Le Moine O, von Renteln D. Efficacy of endoscopic closure of acute perforations of the gastrointestinal tract. Clin Gastroenterol Hepatol 2012; 10: 603-608
  • 3 Akobeng AK. Principles of evidence based medicine. Arch Dis Child 2005; 90: 837-840
  • 4 Dumonceau JM, Hassan C, Riphaus A et al. European Society of Gastrointest Endosc (ESGE) Guideline Development Policy. Endoscopy 2012; 44: 626-629
  • 5 Jauch EC, Saver JL, Adams Jr. HP et al. Guidelines for the early management of patients with acute ischemic stroke: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke 2013; 44: 870-947
  • 6 Lu Y, Loffroy R, Lau JY et al. Multidisciplinary management strategies for acute non-variceal upper gastrointestinal bleeding. Br J Surg 2014; 101: E34-E50
  • 7 Cotton PB, Eisen GM, Aabakken L et al. A lexicon for endoscopic adverse events: report of an ASGE workshop. Gastrointest Endosc 2010; 71: 446-454
  • 8 Raju GS, Saito Y, Matsuda T et al. Endoscopic management of colonoscopic perforations (with videos). Gastrointest Endosc 2011; 74: 1380-1388
  • 9 Baron TH, Wong Kee Song LM, Zielinski MD et al. A comprehensive approach to the management of acute endoscopic perforations (with videos). Gastrointest Endosc 2012; 76: 838-859
  • 10 Jin YJ, Jeong S, Kim JH et al. Clinical course and proposed treatment strategy for ERCP-related duodenal perforation: a multicenter analysis. Endoscopy 2013; 45: 806-812
  • 11 Kuppusamy MK, Felisky C, Kozarek RA et al. Impact of endoscopic assessment and treatment on operative and non-operative management of acute oesophageal perforation. Br J Surg 2011; 98: 818-824
  • 12 Polydorou A, Vezakis A, Fragulidis G et al. A tailored approach to the management of perforations following endoscopic retrograde cholangiopancreatography and sphincterotomy. J Gastrointest Surg 2011; 15: 2211-2217
  • 13 Anderson ML, Pasha TM, Leighton JA. Endoscopic perforation of the colon: lessons from a 10-year study. Am J Gastroenterol 2000; 95: 3418-3422
  • 14 Paspatis GA, Vardas E, Theodoropoulou A et al. Complications of colonoscopy in a large public county hospital in Greece. A 10-year study. Dig Liver Dis 2008; 40: 951-957
  • 15 Kowalczyk L, Forsmark CE, Ben-David K et al. Algorithm for the management of endoscopic perforations: a quality improvement project. Am J Gastroenterol 2011; 106: 1022-1027
  • 16 Carrott Jr. PW, Low DE. Advances in the management of esophageal perforation. Thorac Surg Clin 2011; 21: 541-555
  • 17 Tamiya Y, Nakahara K, Kominato K et al. Pneumomediastinum is a frequent but minor complication during esophageal endoscopic submucosal dissection. Endoscopy 2010; 42: 8-14
  • 18 Fujishiro M, Yahagi N, Kakushima N et al. Successful nonsurgical management of perforation complicating endoscopic submucosal dissection of gastrointestinal epithelial neoplasms. Endoscopy 2006; 38: 1001-1006
  • 19 Maeda Y, Hirasawa D, Fujita N et al. Mediastinal emphysema after esophageal endoscopic submucosal dissection: its prevalence and clinical significance. Dig Endosc 2011; 23: 221-226
  • 20 Raju GS, Fritscher-Ravens A, Rothstein RI et al. Endoscopic closure of colon perforation compared to surgery in a porcine model: a randomized controlled trial (with videos). Gastrointest Endosc 2008; 68: 324-332
  • 21 Fritscher-Ravens A, Hampe J, Grange P et al. Clip closure versus endoscopic suturing versus thoracoscopic repair of an iatrogenic esophageal perforation: a randomized, comparative, long-term survival study in a porcine model (with videos). Gastrointest Endosc 2010; 72: 1020-1026
  • 22 Lin BW, Thanassi W. Tension pneumoperitoneum. J Emerg Med 2010; 38: 57-59
  • 23 Fu K, Ishikawa T, Yamamoto T et al. Paracentesis for successful treatment of tension pneumoperitoneum related to endoscopic submucosal dissection. Endoscopy 2009; 41: E245
  • 24 Dellon ES, Hawk JS, Grimm IS et al. The use of carbon dioxide for insufflation during GI endoscopy: a systematic review. Gastrointest Endosc 2009; 69: 843-849
  • 25 Wang WL, Wu ZH, Sun Q et al. Meta-analysis: the use of carbon dioxide insufflation vs. room air insufflation for gastrointestinal endoscopy. Aliment Pharmacol Ther 2012; 35: 1145-1154
  • 26 Swan MP, Bourke MJ, Moss A et al. The target sign: an endoscopic marker for the resection of the muscularis propria and potential perforation during colonic endoscopic mucosal resection. Gastrointest Endosc 2011; 73: 79-85
  • 27 Braga M, Ljungqvist O, Soeters P et al. ESPEN guidelines on parenteral nutrition: surgery. Clin Nutr 2009; 28: 378-386
  • 28 Fatima J, Baron TH, Topazian MD et al. Pancreaticobiliary and duodenal perforations after periampullary endoscopic procedures: diagnosis and management. Arch Surg 2007; 142: 448-454
  • 29 Castellvi J, Pi F, Sueiras A et al. Colonoscopic perforation: useful parameters for early diagnosis and conservative treatment. Int J Colorect Dis 2011; 26: 1183-1190
  • 30 Ben-Menachem T, Decker GA, Early DS et al. Adverse events of upper GI endoscopy. Gastrointest Endosc 2012; 76: 707-718
  • 31 Soreide JA, Konradsson A, Sandvik OM et al. Esophageal perforation: clinical patterns and outcomes from a patient cohort of Western Norway. Dig Surg 2012; 29: 494-502
  • 32 Broor SL, Lahoti D, Bose PP et al. Benign esophageal strictures in children and adolescents: etiology, clinical profile, and results of endoscopic dilation. Gastrointest Endosc 1996; 43: 474-477
  • 33 Karnak I, Tanyel FC, Buyukpamukcu N et al. Esophageal perforations encountered during the dilation of caustic esophageal strictures. J Cardiovasc Surg (Torino) 1998; 39: 373-377
  • 34 Boeckxstaens GE, Annese V, des Varannes SB et al. Pneumatic dilation versus laparoscopic Heller's myotomy for idiopathic achalasia. N Engl J Med 2011; 364: 1807-1816
  • 35 Campos GM, Vittinghoff E, Rabl C et al. Endoscopic and surgical treatments for achalasia: a systematic review and meta-analysis. Ann Surg 2009; 249: 45-57
  • 36 Moss A, Bourke MJ, Hourigan LF et al. Endoscopic resection for Barrett's high-grade dysplasia and early esophageal adenocarcinoma: an essential staging procedure with long-term therapeutic benefit. Am J Gastroenterol 2010; 105: 1276-1283
  • 37 Pouw RE, Seewald S, Gondrie JJ et al. Stepwise radical endoscopic resection for eradication of Barrett's oesophagus with early neoplasia in a cohort of 169 patients. Gut 2010; 59: 1169-1177
  • 38 Shimizu Y, Takahashi M, Yoshida T et al. Endoscopic resection (endoscopic mucosal resection/ endoscopic submucosal dissection) for superficial esophageal squamous cell carcinoma: current status of various techniques. Dig Endosc 2013; 25: 13-19
  • 39 Neuhaus H, Terheggen G, Rutz EM et al. Endoscopic submucosal dissection plus radiofrequency ablation of neoplastic Barrett's esophagus. Endoscopy 2012; 44: 1105-1113
  • 40 Repici A, Hassan C, Carlino A et al. Endoscopic submucosal dissection in patients with early esophageal squamous cell carcinoma: results from a prospective Western series. Gastrointest Endosc 2010; 71: 715-721
  • 41 Peng A, Li Y, Xiao Z et al. Study of clinical treatment of esophageal foreign body-induced esophageal perforation with lethal complications. Eur Arch Otorhinolaryngol 2012; 269: 2027-2036
  • 42 Ukleja A, Afonso BB, Pimentel R et al. Outcome of endoscopic balloon dilation of strictures after laparoscopic gastric bypass. Surg Endosc 2008; 22: 1746-1750
  • 43 Yoo JH, Shin SJ, Lee KM et al. Risk factors for perforations associated with endoscopic submucosal dissection in gastric lesions: emphasis on perforation type. Surg Endosc 2012; 26: 2456-2464
  • 44 Imagawa A, Okada H, Kawahara Y et al. Endoscopic submucosal dissection for early gastric cancer: results and degrees of technical difficulty as well as success. Endoscopy 2006; 38: 987-990
  • 45 Chung IK, Lee JH, Lee SH et al. Therapeutic outcomes in 1000 cases of endoscopic submucosal dissection for early gastric neoplasms: Korean ESD Study Group multicenter study. Gastrointest Endosc 2009; 69: 1228-1235
  • 46 Toyokawa T, Inaba T, Omote S et al. Risk factors for perforation and delayed bleeding associated with endoscopic submucosal dissection for early gastric neoplasms: analysis of 1123 lesions. J Gastroenterol Hepatol 2012; 27: 907-912
  • 47 Ben-David K, Lopes J, Hochwald S et al. Minimally invasive treatment of esophageal perforation using a multidisciplinary treatment algorithm: a case series. Endoscopy 2011; 43: 160-162
  • 48 Kuppusamy MK, Hubka M, Felisky CD et al. Evolving management strategies in esophageal perforation: surgeons using nonoperative techniques to improve outcomes. J Am Coll Surg 2011; 213: 164-171
  • 49 Soreide JA, Viste A. Esophageal perforation: diagnostic work-up and clinical decision-making in the first 24 hours. Scand J Trauma Resusc Emerg Med 2011; 19: 66
  • 50 Bhatia P, Fortin D, Inculet RI et al. Current concepts in the management of esophageal perforations: a twenty-seven year Canadian experience. Ann Thorac Surg 2011; 92: 209-215
  • 51 Qadeer MA, Dumot JA, Vargo JJ et al. Endoscopic clips for closing esophageal perforations: case report and pooled analysis. Gastrointest Endosc 2007; 66: 605-611
  • 52 Daram SR, Tang SJ, Wu R et al. Benchtop testing and comparisons among three types of through-the-scope endoscopic clipping devices. Surg Endosc 2013; 27: 1521-1529
  • 53 van Boeckel PG, Sijbring A, Vleggaar FP et al. Systematic review: temporary stent placement for benign rupture or anastomotic leak of the oesophagus. Aliment Pharmacol Ther 2011; 33: 1292-1301
  • 54 Johnsson E, Lundell L, Liedman B. Sealing of esophageal perforation or ruptures with expandable metallic stents: a prospective controlled study on treatment efficacy and limitations. Dis Esoph 2005; 18: 262-266
  • 55 van Heel NC, Haringsma J, Spaander MC et al. Short-term esophageal stenting in the management of benign perforations. Am J Gastroenterol 2010; 105: 1515-1520
  • 56 Seven G, Irani S, Ross AS et al. Partially versus fully covered self-expanding metal stents for benign and malignant esophageal conditions: a single center experience. Surg Endosc 2013; 27: 2185-2192
  • 57 Ahrens M, Schulte T, Egberts J et al. Drainage of esophageal leakage using endoscopic vacuum therapy: a prospective pilot study. Endoscopy 2010; 42: 693-698
  • 58 Loske G, Schorsch T, Muller C. Intraluminal and intracavitary vacuum therapy for esophageal leakage: a new endoscopic minimally invasive approach. Endoscopy 2011; 43: 540-544
  • 59 Vallbohmer D, Holscher AH, Holscher M et al. Options in the management of esophageal perforation: analysis over a 12-year period. Dis Esoph 2010; 23: 185-190
  • 60 Dumonceau JM, Cremer M, Lalmand B et al. Esophageal fistula sealing: choice of stent, practical management, and cost. Gastrointest Endosc 1999; 49: 70-78
  • 61 Biancari F, D'Andrea V, Paone R et al. Current treatment and outcome of esophageal perforations in adults: systematic review and meta-analysis of 75 studies. World J Surg 2013; 37: 1051-1059
  • 62 Merchea A, Cullinane DC, Sawyer MD et al. Esophagogastroduodenoscopy-associated gastrointestinal perforations: a single-center experience. Surgery 2010; 148: 876-880
  • 63 Minami S, Gotoda T, Ono H et al. Complete endoscopic closure of gastric perforation induced by endoscopic resection of early gastric cancer using endoclips can prevent surgery (with video). Gastrointest Endosc 2006; 63: 596-601
  • 64 Han JH, Lee TH, Jung Y et al. Rescue endoscopic band ligation of iatrogenic gastric perforations following failed endoclip closure. World J Gastroenterol 2013; 19: 955-959
  • 65 Mangiavillano B, Viaggi P, Masci E. Endoscopic closure of acute iatrogenic perforations during diagnostic and therapeutic endoscopy in the gastrointestinal tract using metallic clips: a literature review. J Dig Dis 2010; 11: 12-18
  • 66 Surace M, Mercky P, Demarquay J-F et al. Endoscopic management of GI fistulae with the over-the-scope clip system (with video). Gastrointest Endosc 2011; 74: 1416-1419
  • 67 von Renteln D, Denzer UW, Schachschal G et al. Endoscopic closure of GI fistulae by using an over-the-scope clip (with videos). Gastrointest Endosc 2010; 72: 1289-1296
  • 68 Parodi A, Repici A, Pedroni A et al. Endoscopic management of GI perforations with a new over-the-scope clip device (with videos). Gastrointest Endosc 2010; 72: 881-886
  • 69 Manta R, Manno M, Bertani H et al. Endoscopic treatment of gastrointestinal fistulas using an over-the-scope clip (OTSC) device: case series from a tertiary referral center. Endoscopy 2011; 43: 545-548
  • 70 Kirschniak A, Subotova N, Zieker D et al. The Over-The-Scope Clip (OTSC) for the treatment of gastrointestinal bleeding, perforations, and fistulas. Surg Endosc 2011; 25: 2901-2905
  • 71 Baron TH, Song LM, Ross A et al. Use of an over-the-scope clipping device: multicenter retrospective results of the first U.S. experience (with videos). Gastrointest Endosc 2012; 76: 202-208
  • 72 Nishiyama N, Mori H, Kobara H et al. Efficacy and safety of over-the-scope clip: including complications after endoscopic submucosal dissection. World J Gastroenterol 2013; 19: 2752-2760
  • 73 Martinek J, Ryska O, Tuckova I et al. Comparing over-the-scope clip versus endoloop and clips (KING closure) for access site closure: a randomized experimental study. Surg Endosc 2013; 27: 1203-1210
  • 74 Matsuda T, Fujii T, Emura F et al. Complete closure of a large defect after EMR of a lateral spreading colorectal tumor when using a two-channel colonoscope. Gastrointest Endosc 2004; 60: 836-838
  • 75 Ladas SD, Kamberoglou D, Vlachogiannakos J et al. Combined use of metallic endoclips and endoloops using a single-channel scope in closing iatrogenic perforations and fistulas: two case reports and a literature review. Eur J Gastroenterol Hepatol 2014; 26: 119-122
  • 76 Tsunada S, Ogata S, Ohyama T et al. Endoscopic closure of perforations caused by EMR in the stomach by application of metallic clips. Gastrointest Endosc 2003; 57: 948-951
  • 77 Iwashita T, Lee JG, Nakai Y et al. Successful management of perforation during cystogastrostomy with an esophageal fully covered metallic stent placement. Gastrointest Endosc 2012; 76: 214-215
  • 78 Eroglu A, Turkyilmaz A, Aydin Y et al. Current management of esophageal perforation: 20 years experience. Dis Esoph 2009; 22: 374-380
  • 79 Freeman RK, Van Woerkom JM, Vyverberg A et al. Esophageal stent placement for the treatment of spontaneous esophageal perforations. Ann Thorac Surg 2009; 88: 194-198
  • 80 Salminen P, Gullichsen R, Laine S. Use of self-expandable metal stents for the treatment of esophageal perforations and anastomotic leaks. Surg Endosc 2009; 23: 1526-1530
  • 81 Amrani L, Menard C, Berdah S et al. From iatrogenic digestive perforation to complete anastomotic disunion: endoscopic stenting as a new concept of "stent-guided regeneration and re-epithelialization". Gastrointest Endosc 2009; 69: 1282-1287
  • 82 Leers JM, Vivaldi C, Schäfer H et al. Endoscopic therapy for esophageal perforation or anastomic leak with a self-expandable metallic stent. Surg Endosc 2009; 10: 2258-2262
  • 83 Kiernan PD, Khandhar SJ, Fortes DL et al. Thoracic esophageal perforations. Am Surg 2010; 76: 1355-1362
  • 84 Schmidt SC, Strauch S, Rosch T et al. Management of esophageal perforations. Surg Endosc 2010; 24: 2809-2813
  • 85 Swinnen J, Eisendrath P, Rigaux J et al. Self-expandable metal stents for the treatment of benign upper GI leaks and perforations. Gastrointest Endosc 2011; 73: 890-899
  • 86 Lazar GJr, Paszt A, Simonka Z et al. A successful strategy for surgical treatment of Boerhaave's syndrome. Surg Endosc 2011; 25: 3613-3619
  • 87 Dai Y, Chopra SS, Kneif S et al. Management of esophageal anastomotic leaks, perforations, and fistulae with self-expanding plastic stents. J Thorac Cardiovasc Surg 2011; 141: 1213-1217
  • 88 D’Cunha J, Rueth NM, Groth SS et al. Esophageal stents for anastomic leaks and perforations. J Thorac Cardiovasc Surg 2011; 142: 39-46
  • 89 Lin Y, Jiang G, Liu L et al. Management of thoracic esophageal perforation. World J Surg 2014; 38: 1093-1099
  • 90 Biancari F, Gudbjartsson T, Mennander A et al. Treatment of esophageal perforation in octogenarians: a multicenter study. Dis Esoph Oct 10 [Epub ahead of print] 2013;
  • 91 Wilson JL, Louie BE, Farivar AS et al. Fully covered self-expanding metal stents are effective for benign esophagogastric disruptions and strictures. J Gastrointest Surg 2013; 17: 2045-2050
  • 92 Wahed S, Dent B, Jones R et al. Spectrum of oesophageal perforations and their influence on management. Br J Surg 2014; 101: E156-E162
  • 93 Schweigert M, Beattie R, Solymosi N et al. Endoscopic stent insertion versus primary operative management for spontaneous rupture of the esophagus (Boerhaave syndrome): an international study comparing the outcome. Am Surg 2013; 79: 634-640
  • 94 Sato H, Inoue H, Ikeda H et al. Clinical experience of esophageal perforation occurring with endoscopic submucosal dissection. Dis Esoph Aug 27 [Epub ahead of print] 2013;
  • 95 Heits N, Stapel L, Reichert B et al. Endoscopic endoluminal vacuum therapy in esophageal perforation. Ann Thorac Surg 2014; 97: 1029-1035
  • 96 Hadj Amor WB, Bonin EA, Vitton V et al. Successful endoscopic management of large upper gastrointestinal perforations following EMR using over-the-scope clipping combined with stenting. Endoscopy 2012; 44: E277-E278
  • 97 Biancari F, Saarnio J, Mennander A et al. Outcome of patients with esophageal perforations: a multicenter study. World J Surg 2014; 38: 902-909
  • 98 Binmoeller KF, Grimm H, Soehendra N. Endoscopic closure of a perforation using metallic clips after snare excision of a gastric leiomyoma. Gastrointest Endosc 1993; 39: 172-174
  • 99 Albuquerque W, Arantes V. Large gastric perforation after endoscopic mucosal resection treated by application of metallic clips (video). Endoscopy 2004; 36: 752-753
  • 100 Katsinelos P, Beltsis A, Paroutoglou G et al. Endoclipping for gastric perforation after endoscopic polypectomy: an alternative treatment to avoid surgery. Surg Laparosc Endosc Percutan Tech 2004; 14: 279-281
  • 101 De Caro G, Pagano N, Malesci A et al. Endoclipping for gastric perforation secondary to second session of EMRC in locally residual early gastric cancer: a case report. Dig Liver Dis 2009; 41: E32-E34
  • 102 Kim HS, Lee DK, Jeong YS et al. Successful endoscopic management of a perforated gastric dysplastic lesion after endoscopic mucosal resection. Gastrointest Endosc 2000; 51: 613-615
  • 103 Shi Q, Chen T, Ren Z et al. [Complete closure of large gastric defects after endo- scopic full-thickness resection, using endoloop and metallic clip interrupted suture. Endoscopy 2013; 45: 329-334
  • 104 Zhong Y, Shi Q, Yao L et al. [Complete closure of gastric wall defect after endoscopic full-thick resection with metal clips and endoloop snare]. Zhonghua Wei Chang Wai Ke Za Zhi (Chinese Journal of Gastrointestinal Surgery 2012; 15: 280-284 [Article in Chinese]
  • 105 Andriulli A, Loperfido S, Napolitano G et al. Incidence rates of post-ERCP complications: a systematic survey of prospective studies. Am J Gastroenterol 2007; 102: 1781-1788
  • 106 Enns R, Eloubeidi MA, Mergener K et al. ERCP-related perforations: risk factors and management. Endoscopy 2002; 34: 293-298
  • 107 Loperfido S, Angelini G, Benedetti G et al. Major early complications from diagnostic and therapeutic ERCP: a prospective multicenter study. Gastrointest Endosc 1998; 48: 1-10
  • 108 Stapfer M, Selby RR, Stain SC et al. Management of duodenal perforation after endoscopic retrograde cholangiopancreatography and sphincterotomy. Ann Surg 2000; 232: 191-198
  • 109 Machado NO. Management of duodenal perforation post-endoscopic retrograde cholangiopancreatography. When and whom to operate and what factors determine the outcome? A review article. JOP 2012; 13: 18-25
  • 110 Howard TJ, Tan T, Lehman GA et al. Classification and management of perforations complicating endoscopic sphincterotomy. Surgery 1999; 126: 658-663
  • 111 Preetha M, Chung YF, Chan WH et al. Surgical management of endoscopic retrograde cholangiopancreatography-related perforations. ANZ J Surg 2003; 73: 1011-1014
  • 112 Alfieri S, Rosa F, Cina C et al. Management of duodeno-pancreato-biliary perforations after ERCP: outcomes from an Italian tertiary referral center. Surg Endosc 2013; 27: 2005-2012
  • 113 Shami VM, Talreja JP, Mahajan A et al. EUS-guided drainage of bilomas: a new alternative?. Gastrointest Endosc 2008; 67: 136-140
  • 114 Chung RS, Sivak MV, Ferguson DR. Surgical decisions in the management of duodenal perforation complicating endoscopic sphincterotomy. Am J Surg 1993; 165: 700-703
  • 115 Kayhan B, Akdogan M, Sahin B. ERCP subsequent to retroperitoneal perforation caused by endoscopic sphincterotomy. Gastrointest Endosc 2004; 60: 833-835
  • 116 Knudson K, Raeburn CD, Mcintyre RC et al. Management of duodenal and pancreaticobiliary perforations associated with periampullary endoscopic procedures. Am J Surg 2008; 196: 975-981
  • 117 Rahbour G, Siddiqui MR, Ullah MR et al. A meta-analysis of outcomes following use of somatostatin and its analogues for the management of enterocutaneous fistulas. Ann Surg 2012; 256: 946-954
  • 118 Coughlin S, Roth L, Lurati G et al. Somatostatin analogues for the treatment of enterocutaneous fistulas: a systematic review and meta-analysis. World J Surg 2012; 36: 1016-1029
  • 119 Koti RS, Gurusamy KS, Fusai G et al. Meta-analysis of randomized controlled trials on the effectiveness of somatostatin analogues for pancreatic surgery: a Cochrane review. HPB (Oxford) 2010; 12: 155-165
  • 120 Assalia A, Suissa A, Ilivitzki A et al. Validity of clinical criteria in the management of endoscopic retrograde cholangiopancreatography related duodenal perforations. Arch Surg 2007; 142: 1059-1064
  • 121 Avgerinos DV, Llaguna OH, Lo AY et al. Management of endoscopic retrograde cholangiopancreatography: related duodenal perforations. Surg Endosc 2009; 23: 833-838
  • 122 Dubecz A, Ottmann J, Schweigert M et al. Management of ERCP-related small bowel perforations: the pivotal role of physical investigation. Can J Surg 2012; 55: 99-104
  • 123 Kim BS, Kim IG, Ryu BY et al. Management of endoscopic retrograde cholangiopancreatography-related perforations. J Korean Surg Soc 2011; 81: 195-204
  • 124 Kim J, Lee SH, Paik WH et al. Clinical outcomes of patients who experienced perforation associated with endoscopic retrograde cholangiopancreatography. Surg Endosc 2012; 26: 3293-3300
  • 125 Kwon W, Jang J-Y, Ryu JK et al. Proposal of an endoscopic retrograde cholangiopancreatography-related perforation management guideline based on perforation type. J Korean Surg Soc 2012; 83: 218-226
  • 126 Mao Z, Zhu Q, Wu W et al. Duodenal perforations after endoscopic retrograde cholangiopancreatography: experience and management. J Laparoendosc Adv Surg Tech A 2008; 18: 691-695
  • 127 Morgan KA, Fontenot BB, Ruddy JM et al. Endoscopic retrograde cholangiopancreatography gut perforations: when to wait!. When to operate! Am Surg 2009; 75: 477-483
  • 128 Wu HM, Dixon E, May GR et al. Management of perforation after endoscopic retrograde cholangiopancreatography (ERCP): a population-based review. HPB (Oxford) 2006; 8: 393-399
  • 129 Jung JH, Choi KD, Ahn JY et al. Endoscopic submucosal dissection for sessile, nonampullary duodenal adenomas. Endoscopy 2013; 45: 133-135
  • 130 Hanaoka N, Uedo N, Ishihara R et al. Clinical features and outcomes of delayed perforation after endoscopic submucosal dissection for early gastric cancer. Endoscopy 2010; 42: 1112-1115
  • 131 Abe Y, Inamori M, Iida H et al. Clinical characteristics of patients with gastric perforation following endoscopic submucosal resection for gastric cancer. Hepatogastroenterology 2009; 56: 921-924
  • 132 Saito Y, Fukuzawa M, Matsuda T et al. Clinical outcome of endoscopic submucosal dissection versus endoscopic mucosal resection of large colorectal tumors as determined by curative resection. Surg Endosc 2010; 24: 343-352
  • 133 Conio M, De Ceglie A, Filiberti R et al. Cap-assisted EMR of large, sporadic, nonampullary duodenal polyps. Gastrointest Endosc 2012; 76: 1160-1169
  • 134 Alexander S, Bourke MJ, Williams SJ et al. EMR of large, sessile, sporadic nonampullary duodenal adenomas: technical aspects and long-term outcome (with videos). Gastrointest Endosc 2009; 69: 66-73
  • 135 Moschler O, May A, Muller MK et al. Complications in and performance of double-balloon enteroscopy (DBE): results from a large prospective DBE database in Germany. Endoscopy 2011; 43: 484-489
  • 136 Gerson LB, Tokar J, Chiorean M et al. Complications associated with double balloon enteroscopy at nine US centers. Clin Gastroenterol Hepatol 2009; 7: 1177-1182
  • 137 Palmer JS, Marenah K, El Madani F et al. Small bowel perforation following capsule endoscopy: a case report. Ann R Coll Surg Engl 2011; 93: E69-E70
  • 138 Yitzhak A, Bayme M, Perry ZH et al. Small bowel perforation after capsule endoscopy in a patient with occult gastrointestinal bleeding and undiagnosed Crohn’s disease. Am Surg 2012; 78: E159-E161
  • 139 Um S, Poblete H, Zavotsky J. Small bowel perforation caused by an impacted endocapsule. Endoscopy 2008; 40: E122-E123
  • 140 Despott EJ, Gupta A, Burling D et al. Effective dilation of small-bowel strictures by double-balloon enteroscopy in patients with symptomatic Crohn’s disease (with video). Gastrointest Endosc 2009; 70: 1030-1036
  • 141 Espinel J, Pinedo E. Stenosis in gastric bypass: Endoscopic management. World J Gastrointest Endosc 2012; 4: 290-295
  • 142 Donatelli G, Vergeau BM, Dritsas S et al. Closure with an over-the-scope clip allows therapeutic ERCP to be safely performed after acute duodenal perforation during diagnostic endoscopic ultrasound. Endoscopy 2013; 45: E392-E393
  • 143 Balmadrid B, Ross A. Severe laceration in a percutaneous endoscopic jejunostomy placement resolved with over-the-scope clips. Gastrointest Endosc 2013; 45: 783-784
  • 144 Palanivelu C, Jategaonkar PA, Rangarajan M et al. Laparoscopic management of a retroperitoneal duodenal perforation following ERCP for periampullary cancer. JSLS 2008; 12: 399-402
  • 145 Ahlawat SK, Haddad N. Repair of an EUS-induced duodenal perforation with endoscopic clips. Acta Gastroenterol Belg 2009; 72: 361-364
  • 146 Honda T, Yamamoto H, Osawa H et al. Endoscopic submucosal dissection for superficial duodenal neoplasms. Dig Endosc 2009; 21: 270-274
  • 147 Nakagawa Y, Nagai T, Soma W et al. Endoscopic closure of a large ERCP-related lateral duodenal perforation by using endoloops and endoclips. Gastrointest Endosc 2010; 72: 216-217
  • 148 Farhat S, Chaussade S, Ponchon T et al. Endoscopic submucosal dissection in a European setting. A multi-institutional report of a technique in development. Endoscopy 2011; 43: 664-670
  • 149 Lee TH, Bang BW, Jeong JI et al. Primary endoscopic approximation suture under cap-assisted endoscopy of an ERCP-induced duodenal perforation. World J Gastroenterol 2010; 16: 2305-2310
  • 150 Ercan M, Bostanci EB, Dalgic T et al. Surgical outcome of patients with perforation after endoscopic retrograde cholangiopancreatography. J Laparosc Endosc Adv Surg Tech A 2012; 22: 371-377
  • 151 Fanning SB, Bourke MJ, Williams SJ et al. Giant laterally spreading tumors of the duodenum: endoscopic resection outcomes, limitations, and caveats. Gastrointest Endosc 2012; 75: 805-812
  • 152 Samarasena JB, Nakai Y, Park DH et al. Endoscopic closure of an iatrogenic duodenal perforation: a novel technique using endoclips, endoloop, and fibrin glue. Endoscopy 2012; 44: E424-E425
  • 153 Gubler C, Bauerfeind P. Endoscopic closure of iatrogenic gastrointestinal tract perforations with the over-the-scope clip. Digestion 2012; 85: 302-307
  • 154 Matsumoto S, Miyatani H, Yoshida Y. Endoscopic submucosal dissection for duodenal tumors: a single-center experience. Endoscopy 2013; 45: 136-137
  • 155 Rabie ME, Mir NH, Al Skaini MS et al. Operative and non-operative management of endoscopic retrograde cholangiopancreatography-associated duodenal injuries. Ann R Coll Surg Engl 2013; 95: 285-290
  • 156 Teruel C, Garcia XA, Ledo A et al. Small intestine perforation after colonoscopy: rare complication in patients with previous abdominal surgery. Endoscopy 2009; 41: E116
  • 157 Campos JM, Mello FS, Ferraz AA et al. Endoscopic dilation of gastrojejunal anastomosis after gastric bypass. Arq Bras Cir Dig 2012; 25: 283-289
  • 158 Korman LY, Overholt BF, Box T et al. Perforation during colonoscopy in endoscopic ambulatory surgical centers. Gastrointest Endosc 2003; 58: 554-557
  • 159 Rabeneck L, Paszat LF, Hilsden RJ et al. Bleeding and perforation after outpatient colonoscopy and their risk factors in usual clinical practice. Gastroenterology 2008; 135: 1899-1906
  • 160 Saunders BP, Fukumoto M, Halligan S et al. Why is colonoscopy more difficult in women?. Gastrointest Endosc 1996; 43: 124-126
  • 161 Navaneethan U, Kochhar G, Phull H et al. Severe disease on endoscopy and steroid use increase the risk for bowel perforation during colonoscopy in inflammatory bowel disease patients. J Crohns Colitis 2012; 6: 470-475
  • 162 Rutter MD, Saunders BP, Wilkinson KH et al. Thirty-year analysis of a colonoscopic surveillance program for neoplasia in ulcerative colitis. Gastroenterology 2006; 130: 1030-1038
  • 163 Luning TH, Keemers-Gels ME, Barendregt WB et al. Colonoscopic perforations: a review of 30,366 patients. Surg Endosc 2007; 21: 994-997
  • 164 Putcha RV, Burdick JS. Management of iatrogenic perforation. Gastroenterol Clin North Am 2003; 32: 1289-1309
  • 165 Tribonias G, Konstantinidis K, Theodoropoulou A et al. Rectal perforation caused by colonoscopic retroflexion. Gastrointest Endosc 2010; 71: 662
  • 166 Loffeld RJ, Engel A, Dekkers PE. Incidence and causes of colonoscopic perforations: a single-center case series. Endoscopy 2011; 43: 240-242
  • 167 Stock C, Ihle P, Sieg A et al. Adverse events requiring hospitalization within 30 days after outpatient screening and nonscreening colonoscopies. Gastrointest Endosc 2013; 77: 419-429
  • 168 Lee TJ, Rutter MD, Blanks RG et al. Colonoscopy quality measures: experience from the NHS Bowel Cancer Screening Programme. Gut 2012; 61: 1050-1057
  • 169 Rabeneck L, Saskin R, Paszat LF. Onset and clinical course of bleeding and perforation after outpatient colonoscopy: a population-based study. Gastrointest Endosc 2011; 73: 520-523
  • 170 Saunders BP, Brown GJ, Lemann M et al. Balloon dilation of ileocolonic strictures in Crohn’s disease. Endoscopy 2004; 36: 1001-1007
  • 171 Small AJ, Coelho-Prabhu N, Baron TH. Endoscopic placement of self-expandable metal stents for malignant colonic obstruction: long-term outcomes and complication factors. Gastrointest Endosc 2010; 71: 560-572
  • 172 Suzuki N, Saunders BP, Thomas-Gibson S et al. Colorectal stenting for malignant and benign disease: outcomes in colorectal stenting. Dis Colon Rectum 2004; 47: 1201-1207
  • 173 Bowles CJ, Leicester R, Romaya C et al. A prospective study of colonoscopy practice in the UK today: are we adequately prepared for national colorectal cancer screening tomorrow?. Gut 2004; 53: 277-283
  • 174 Heldwein W, Dollhopf M, Rosch T et al. The Munich Polypectomy Study (MUPS): prospective analysis of complications and risk factors in 4000 colonic snare polypectomies. Endoscopy 2005; 37: 1116-1122
  • 175 Heresbach D, Kornhauser R, Seyrig JA et al. A national survey of endoscopic mucosal resection for superficial gastrointestinal neoplasia. Endoscopy 2010; 42: 806-813
  • 176 Moss A, Bourke MJ, Williams SJ et al. Endoscopic mucosal resection outcomes and prediction of submucosal cancer from advanced colonic mucosal neoplasia. Gastroenterology 2011; 140: 1909-1918
  • 177 Buchner AM, Guarner-Argente C, Ginsberg GG. Outcomes of EMR of defiant colorectal lesions directed to an endoscopy referral center. Gastrointest Endosc 2012; 76: 255-263
  • 178 Kim ES, Cho KB, Park KS et al. Factors predictive of perforation during endoscopic submucosal dissection for the treatment of colorectal tumors. Endoscopy 2011; 43: 573-578
  • 179 Toyonaga T, Man-i M, East JE et al. 1,635 Endoscopic submucosal dissection cases in the esophagus, stomach, and colorectum: complication rates and long-term outcomes. Surg Endosc 2013; 27: 1000-1008
  • 180 Tanaka S, Terasaki M, Kanao H et al. Current status and future perspectives of endoscopic submucosal dissection for colorectal tumors. Dig Endosc 2012; 24: 73-79
  • 181 Repici A, Hassan C, De Paula Pessoa D et al. Efficacy and safety of endoscopic submucosal dissection for colorectal neoplasia: a systematic review. Endoscopy 2012; 44: 137-150
  • 182 Metz AJ, Moss A, McLeod D et al. A blinded comparison of the safety and efficacy of hot biopsy forceps electrocauterization and conventional snare polypectomy for diminutive colonic polypectomy in a porcine model. Gastrointest Endosc 2013; 77: 484-490
  • 183 Zissin R, Hertz M, Osadchy A et al. Abdominal CT findings in nontraumatic colorectal perforation. Eur J Radiol 2008; 65: 125-132
  • 184 Iqbal CW, Cullinane DC, Schiller HJ et al. Surgical management and outcomes of 165 colonoscopic perforations from a single institution. Arch Surg 2008; 143: 701-706
  • 185 Ignjatovic A, Saunders BP. A clinical case of delayed caecal perforation. Gut 2009; 58: 1170-1171
  • 186 La Torre M, Velluti F, Giuliani G et al. Promptness of diagnosis is the main prognostic factor after colonoscopic perforation. Colorectal Dis 2012; 14: E23-E26
  • 187 Bassan MS, Holt B, Moss A et al. Carbon dioxide insufflation reduces number of postprocedure admissions after endoscopic resection of large colonic lesions: a prospective cohort study. Gastrointest Endosc 2013; 77: 90-95
  • 188 Gayer G, Hertz M, Zissin R. Postoperative pneumoperitoneum: prevalence, duration, and possible significance. Semin Ultrasound CT MR 2004; 25: 286-289
  • 189 Raju GS, Ahmed I, Xiao SY et al. Controlled trial of immediate endoluminal closure of colon perforations in a porcine model by use of a novel clip device (with videos). Gastrointest Endosc 2006; 64: 989-997
  • 190 Magdeburg R, Collet P, Post S et al. Endoclipping of iatrogenic colonic perforation to avoid surgery. Surg Endosc 2008; 22: 1500-1504
  • 191 Byeon JS. Colonic perforation: can we manage it endoscopically?. Clin Endosc 2013; 46: 495-499
  • 192 Magdeburg R, Sold M, Post S et al. Differences in the endoscopic closure of colonic perforation due to diagnostic or therapeutic colonoscopy. Scand J Gastroenterol 2013; 48: 862-867
  • 193 Jovanovic I, Zimmermann L, Fry LC et al. Feasibility of endoscopic closure of an iatrogenic colon perforation occurring during colonoscopy. Gastrointest Endosc 2011; 73: 550-555
  • 194 Singhal S, Changela K, Papafragkakis H et al. Over the scope clip: technique and expanding clinical applications. J Clin Gastroenterol 2013; 47: 749-756
  • 195 Weiland T, Fehlker M, Gottwald T et al. Performance of the OTSC System in the endoscopic closure of iatrogenic gastrointestinal perforations: a systematic review. Surg Endosc 2013; 27: 2258-2274
  • 196 Han JH, Park S, Youn S. Endoscopic closure of colon perforation with band ligation; salvage technique after endoclip failure. Clin Gastroenterol Hepatol 2011; 9: E54-E55
  • 197 Cho SB, Lee WS, Joo YE et al. Therapeutic options for iatrogenic colon perforation: feasibility of endoscopic clip closure and predictors of the need for early surgery. Surg Endosc 2012; 26: 473-479
  • 198 Pilgrim CH, Nottle PD. Laparoscopic repair of iatrogenic colonic perforation. Surg Laparosc Endosc Percutan Tech 2007; 17: 215-217
  • 199 Bleier JI, Moon V, Feingold D et al. Initial repair of iatrogenic colon perforation using laparoscopic methods. Surg Endosc 2008; 22: 646-649