Management laparo endoscopic perforation post ERCP

Abstract

Background: Presentation as a case report of a post-ERCP perforation and its conservative surgical management by laparoendoscopic "Rendez Vous" technique (RVLE) in a patient with a history of cholecystectomy. Methods: Post-ERCP perforation is a rare complication but with high morbidity and mortality in cases with late diagnosis. This is why some authors suggest an urgent surgical procedure due to the deterioration of the patient's clinical status, since its natural course is towards septic shock. Results: Therapeutic behavior, whether conservative or surgical, depends, in addition to the clinical status of the patient, the site of perforation and the diagnostic moment (intra or postoperative). RVLE is a tool used to access the main biliary tract in cases of cholecystocytocholithiasis, which consists of cannulation of the biliary tract or endoscopic sphincterotomy through a transcystic-transpapillary guide, thus avoiding the need for instrumentation of the Bile duct decreasing the likelihood of adverse effects. Conclusion: In our case, the re-dissection of the cystic duct with the subsequent RVLE technique allowed the successful cannulation of the biliary tract with the consequent removal of the colejicillar lithiasis and subsequent placement of biliary stents.