COMPLICATIONS OF TRANSPAPILLARY ENDOSCOPIC INTERVENTIONS (TEI)

  • T. I. Tamm
  • K. A. Kramarenko
  • I. N. Mamontov
  • V. V. Nepomnyashchy
  • A. P. Zakharchuk
  • I. Zulfigarov
Keywords: transpapillary endoscopic intervention, endoscopic papillosphincterotomy, duodenal perforation, acute pancreatitis.

Abstract

Summary. Objective — a retrospective analysis of the causes of TEI complications and the results of their treatment.

Materials and methods. The long-term results of performed TEI in 2909 patients were analyzed. The most common indication for TEI was choledocholithiasis, which was found in 1873 (65.4 %) patients and stenosis of papilla was detected in 454 (15.6 %) patients. Complications arose in 112 (3.85 %) patients. 4 (0.14 %) patients died.

Results. Bleeding occurred in 28 (0.96 %) patients. In 12 of 26 patients, endoscopic hemostatic manipulations were additionally performed. Two patients with profuse bleeding from a papillotomy wound were urgently operated on, one patient died. Acute pancreatitis occurred in 68 (2.33 %) patients, of which 56 (1.92 %) had an edematous form, and 12 (0.41 %) patients had a destructive form. 11 patients were operated on from 2 to 15 days from the onset of the disease. Two patients with pancreatic necrosis died of intoxication, the source of which was progressive retroperitoneal necrosis. In 5 (0.17 %) patients, intervention on the papilla was complicated by perforation of the wall of the duodenum. 4 out of 5 patients were urgently operated on (B-2 antrumectomy, external drainage of the common bile duct and retro duodenal space). All 4 patients recovered. In 1 patient, complication was diagnosed on the 5th day after the intervention, which led to delayed surgery and the death of the patient. In 11 patients (0.38 %), a Dormia basket with a stone in the distal part of the common bile duct wedged when trying to extract it. Only one of 11 patients was operated on as planned; in the remaining 10, the problem was resolved with repeated TEI.

Conclusions. Punctual technical implementation of all stages of manipulation, selective cannulation of the bile ducts, careful x-ray control of the position and advancement of the instrument in the ducts helps to reduce the number of complications after TEI.

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Published
2020-02-20
How to Cite
Tamm, T. I., Kramarenko, K. A., Mamontov, I. N., Nepomnyashchy, V. V., Zakharchuk, A. P., & Zulfigarov, I. (2020). COMPLICATIONS OF TRANSPAPILLARY ENDOSCOPIC INTERVENTIONS (TEI). Kharkiv Surgical School, (1), 104-108. https://doi.org/10.37699/2308-7005.1.2020.16
Section
QUESTIONS OF SURGERY OF PANCREATOBILIARY SYSTEM