Primary endoscopic approximation suture under cap-assisted endoscopy of an ERCP-induced duodenal perforation

Table 1 Patient characteristics

Case No.	Age (yr)/sex	ERCP indication	Perforation site	Perforation size (mm)	Diagnosis	Experience of ERCPs (yr)
Case 1	80/F	Klatskin tumor	Bulb	> 10	During ERCP	< 2
Case 2	72/F	IHD stricture	2nd portion, lateral wall	> 10	During ERCP	< 2
Case 3	69/F	Jaundice	2nd portion, lateral wall	> 10	During ERCP	< 1
Case 4	63/M	Choledocholithiasis	2nd portion, lateral wall	> 10	During ERCP	< 1

ERCP: Endoscopic retrograde cholangiopancreatography; IHD: Intrahepatic duct.

Table 2 Therapeutic outcomes

Case No.	No. of endoclip	Antibiotics (d)	PPI	Gastric drainage	Biliary drainage	Start diet/hospital stay (d)	Mortality or Cx.
Case 1	8	3rd generation cephalosporin/metronidazole (7/5)	Pantoprazole 40 mg IV	-	PTBD	6/12	-
Case 2	5	3rd generation cephalosporin/metronidazole (7/3)	Pantoprazole 40 mg IV	-	PTBD, PTCS	7/10	-
Case 3	4	3rd generation cephalosporin/metronidazole (8/5)	Pantoprazole 40 mg IV	-	PTBD	8/10	-
Case 4	5	3rd generation cephalosporin/metronidazole (14/7)	Pantoprazole 40 mg IV	-	PTBD	4/27	-

PPI: Proton pump inhibitor; PTBD: Percutaneous transhepatic biliary drainage; PTCS: Percutaneous transhepatic cholangioscopy.