SEZGİN YILMAZ, Ogün ERŞEN, Serkan ADEMOĞLU, MURAT AKICI, Ayşe KOYUN

CERRAHİ TEKNİK: ENDOSKOPİK SFİNKTEROTOMİYE BAĞLI PERİAMPULLAR RETROPERİTONEAL PERFORASYONDA TRANSDUODENAL T-TÜP TEKNİĞİ

Endoskopik retrograd kolanjiopankreatografi (ERCP) pro-fesyonelleşmek için uzun bir öğrenme eğrisi bulunan ileri endoskopik tekniktir. ERCP işleminde standart endosko-pik tekniklere göre ciddi komplikasyonlar gelişme riski daha yüksektir. Perforasyon ERCP’nin nadir ancak en kor-kulan ve en fazla mortalite ile ilişkili olan komplikasyonla-rından birisidir. Endoskopik sfinkterotomi (ES) prosedüre eklendiğinde %0.3’ten %1’e varan oranlarda perforasyon gelişmektedir ve bu hastalar da %16-18 oranla mortal seyretmektedir. Perforasyon ile operasyon arasında ge-çen süre mortalite ile ilişkili önemli bir faktördür. Geci-ken cerrahilerde mortalite önemli ölçüde artmaktadır. ERCP’ye bağlı perforasyonlarda standart bir cerrahi yak-laşım bulunmamaktadır. Bu çalışmada ERCP nedenli peri-ampullar retroperitoneal perforasyon gelişen hastalarda-ki deneyimimiz nedeniyle ERCP perforasyonlarına cerrahi yaklaşımımızı aktarmayı amaçladık.

SURGICAL TECHNIQUE: TRANSDUODENAL T-TUBE TECHNIC FOR PERIAMPULLARY RETROPERITONEAL PERFORATİON DUE TO THE ENDOSCOPIC SPHINCTEROTOMY

Endoscopic retrograde cholangiopancreatography (ERCP) is an advanced endoscopic technique which has a long learning curve to develop proficiency and higher potential for serious complications than any other stan-dard endoscopic technique. Perforation is a rare but one of the most feared complications complication of (ERCP), but it is surely associated with mortality. When endos-copic sphincterotomy (ES) added to procedure perfora-tion occurs in 0.3% to 1% of patients, and that carries a mortality rate of 16% to 18%. The interval between the perforation and the operation is of great significance. The mortality rate increases dramatically with late surgical management. There is no standard surgical approach to perforations related with ERCP. In this study we present our experience for surgical management of ERCP-related periampullary retroperitoneal perforations.

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