Work

A novel surgical technique for repairing duodenal and bile duct perforations following endoscopic retrograde cholangiopancreatography

Year: 2025

Type: article

Abstract: Duodenal perforation (DP), though rare, is a severe complication of Endoscopic retrograde cholangiopancreatography (ERCP) with high mortality rates. This report introduces a novel surgical approach for repairing a complex combined bile duct and duodenal perforation. A 37-year-old male with recurrent pyloric stenosis and choledocholithiasis, previously treated with multiple procedures, presented with gastric outlet and bile duct obstruction. Following a complex ERCP, he developed a large combined duodenal and bile duct perforation requiring urgent surgical intervention. A 40% circumferential duodenal perforation combined with bile duct perforation was repaired using a novel approach: a vascularized isolated distal gastric pouch was created and anastomosed to the duodenal and bile duct defects. A Roux-en-Y gastrojejunostomy was performed, and the patient recovered in stable condition. When traditional reconstruction is not feasible for DP, an isolated, vascularized distal gastric pouch offers a less invasive alternative and reduces the risk of morbidity.

Source: Journal of Surgical Case Reports

DOI: 10.1093/jscr/rjaf050

Authors: Hana Abdirahman, Omar Barakat, Alexis Nichols, Oluwatobi Soares, Jared Mortus, Vivi Chen

Institution: Baylor College of Medicine

Language: English

Topic: Gallbladder and Bile Duct Disorders

Subfield: Pulmonary and Respiratory Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $1,000