Abstract
Perforations during endoscopic retrograde cholangiopancreatography (ERCP) is a rare
but dreadful complication. Type I Stapfer's perforations tend to be large and can
get easily complicated by peritonitis and collections if not recognized and managed
in a timely manner. With advancement in endoscopic accessories, endoscopic closure
is usually attempted first, and surgical interventions are reserved only in patients
with a failed endoscopic attempt. Though over the scope clips (OTSC) are used in patients
with defect up to 20 to 25 mm in gastric or duodenal perforation and up to 30 mm in
colonic perforations, larger defects can be also closed with the right use of adjuvant
accessories. Here, we report our experience of successful closure of a large duodenal
perforation during ERCP, using a single OTSC clip with help of accessories.
Keywords
conservative - endoscopy - OVESCO
