Abstract
Introduction: Traditionally, surgery was considered a more appropriate method of management for post-ERCP perforation; however, in the past decade a more selective approach has evolved with conservative and endoscopic management options being available. Method: A systematic reviewand meta-analysis was conducted according to the Preferred Reporting Items forSystematic Reviews and Meta-Analyses (PRISMA) guidelines and the Cochrane Handbook for Systematic Reviews ofInterventions. Results: In total,10 comparative studies and 223 patients with post-ERCP perforations was included in the present study. In type I and II perforations, the success rate of initial surgical management was higher, compared to non-operative management (NOM) group(p= 0.09 and p= 0.02 respectively). There was no statistically significant difference in mortality ratesand length of hospital stay between initial surgical and NOM management for any type of perforation. Conclusions: In the present study, the significance of the initial management of patients with post ERCP perforations was demonstrated. When a surgical or even an endoscopic approach is decided the patient should immediately be evaluated by an experienced surgeon or endoscopist.
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