Clinical Endoscopy

  • 제42권1호
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  • Pages.57-61
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  • 2011
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  • 2234-2400(pISSN)
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  • 2234-2443(eISSN)
대한소화기내시경학회 (The Korean Society of Gastrointestinal Endoscopy)
권호 표지

내시경 삽입 중 발생한 십이지장 천공의 성공적인 치료 3예

Three Cases of Successful Treatment of Iatrogenic Duodenal Perforation

  • 류충헌 (울산대학교 의과대학 서울아산병원 소화기내과학교실) ;
  • 박도현 (울산대학교 의과대학 서울아산병원 소화기내과학교실) ;
  • 김명환 (울산대학교 의과대학 서울아산병원 소화기내과학교실) ;
  • 서동완 (울산대학교 의과대학 서울아산병원 소화기내과학교실) ;
  • 이상수 (울산대학교 의과대학 서울아산병원 소화기내과학교실) ;
  • 이성구 (울산대학교 의과대학 서울아산병원 소화기내과학교실) ;
  • 김홍준 (울산대학교 의과대학 서울아산병원 소화기내과학교실)
  • Ryu, Choong-Heon (Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Park, Do-Hyun (Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Kim, Myung-Hwan (Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Seo, Dong-Wan (Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Lee, Sang-Soo (Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Lee, Sung-Koo (Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Kim, Hong-Jun (Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine)
  • 발행 : 2011.01.30
⟨ 이전 논문 다음 논문 ⟩

초록

내시경 역행성 췌담관 조영술은 췌담도 질환의 진단과 치료에 있어 필수적인 검사이고, 최근 내시경 술기 및 기구의 발전으로 시술의 기회가 많아짐에 따라 천공 등의 합병증이 발생할 가능성이 높아지고 있다. 의인성 십이지장 천공의 치료원칙은 현재까지 수술적 봉합이지만, 최근 내시경을 이용한 금속클립을 사용하여 성공적인 봉합술을 시도한 여러 예가 보고되었다. 이에 저자들은 내시경 역행성 췌담관 조영술 시행을 위해 십이지장 진입 중 발생한 천공을 내시경 금속 클립 및 fibrin glue를 이용하여 성공적인 치료를 경험하였기에 보고하는 바이다.

Endoscopic retrograde cholangiopancreatography has become a standard procedure for the diagnosis and treatment of pancreatobiliary disease. Like any invasive procedure, it carries a small, but significant rate of serious complications such as duodenal perforation. Primary surgical closure is the treatment of choice for the cases of duodenal perforation. However, there have been some case reports in which endoscopic metal clip closure of an iatrogenic duodenal perforation was successful. We experienced three cases of successful treatment of the iatrogenic duodenal perforation using endoscopic clipping and fibrin glue injections during a duodenoscope insertion.

키워드

참고문헌

  1. Howard TJ, Tan T, Lehman GA, et al. Classification and management of perforations complicating endoscopic sphincterotomy. Surgery 1999;126:658-663. https://doi.org/10.1016/S0039-6060(99)70119-4
  2. Mutignani M, Iacopini F, Dokas S, et al. Successful endoscopic closure of a lateral duodenal perforation at ERCP with fibrin glue. Gastrointest Endosc 2006;63:725-727. https://doi.org/10.1016/j.gie.2005.11.028
  3. 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. https://doi.org/10.1111/j.1751-2980.2009.00414.x
  4. Vandervoort J, Soetikno RM, Tham TC, et al. Risk factors for complications after performance of ERCP. Gastrointest Endosc 2002;56:652-656. https://doi.org/10.1016/S0016-5107(02)70112-0
  5. Cotton PB, Lehman G, Vennes J, et al. Endoscopic sphincterotomy complications and their management: an attempt at consensus. Gastrointest Endosc 1991;37:383-393. https://doi.org/10.1016/S0016-5107(91)70740-2
  6. Choi JS, Kim MH, Lee SS, et al. The clinical course of ERCP-related bowel perforation. Korean J Gastrointest Endosc 2004;29:63-69.
  7. Enns R, Eloubeidi MA, Mergener K, et al. ERCP-related perforations: risk factors and management. Endoscopy 2002;34:293-298. https://doi.org/10.1055/s-2002-23650
  8. Freeman ML, DiSario JA, Nelson DB, et al. Risk factors for post-ERCP pancreatitis: a prospective, multicenter study. Gastrointest Endosc 2001;54:425-434. https://doi.org/10.1067/mge.2001.117550
  9. Stapfer M, Selby RR, Stain SC, et al. Management of duodenal perforation after endoscopic retrograde cholangiopancreatography and sphincterotomy. Ann Surg 2000;232:191-198. https://doi.org/10.1097/00000658-200008000-00007
  10. Raju GS, Ahmed I, Brining D, Xiao SY. Endoluminal closure of large perforations of colon with clips in a porcine model (with video). Gastrointest Endosc 2006;64:640-646. https://doi.org/10.1016/j.gie.2006.02.040
  11. 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. https://doi.org/10.1055/s-2006-944775
  12. 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. https://doi.org/10.1016/j.gie.2009.10.040