Stapfer classification and managements of ERCP-related gastrointestinal perforation

Objective To explore the therapeutic efficacy of ERCP-related perforation according to Stapfer type. Methods Data of 10 cases of ERCP-related perforation from January 2006 to July 2012 in our hospital were reviewed. These cases were categorized according to Stapler classification. Differences in diagnosis, managements and clinical outcomes for different types of perforation were compared. Results There were 3 cases of type I perforation （ discovered during ERCP）, who were treated by suture of the perforation with T-drain. The mean hospitalization was 36 days. Inflammation occurred in 1 patient. There were 6 cases of type II perforation （ periVaterian）, in which 5 were diagnosed by CT. One of these 6 patients was cured with conventional treatment, and 5 received surgery, including suture in 2, suture plus T-drain in 2 and duodenal diversion in 1. The mean hospitalization of type I1 perforation was 50. 6 days. There was 1 case of type III perforation （bile duct）, who was diagnosed by CT and cured conservatively, with 10. 0 days of hospitalization. There was no death in these 10 patients. Conclusion CT is the best method to diagnose ER- CP-related perforation. The type of perforation and time of diagnosis can determine its management ap- proach, surgery procedure and outcome. Key words: Endoscopic retrograde cholangiopancreatography;  Gastrointestinal perforation; Stapfer type;  Diagnosis and therapy