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Hépato-Gastro & Oncologie Digestive

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Management of iatrogenic colonic endoscopic perforation: the surgical point of view Volume 23, issue 5, Mai 2016

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Authors
1 Hôpital La Pitié-Salpêtrière,
Université Paris 6,
service de chirurgie digestive et hépato-bilaire,
47-83 Boulevard de l’Hôpital,
75013 Paris,
France
2 Hôpital La Pitié Salpêtrière,
Université Paris 6,
service d’hépato-gastroentérologie et oncologie digestive,
47-83 Boulevard de l’Hôpital,
75013 Paris,
France
3 Hôpital Cochin,
Université Paris 5,
service de gastroentérologie et oncologie digestive,
27 Rue du Faubourg Saint-Jacques,
75014 Paris,
France
4 Hôpital Henri Mondor,
Université Paris-Est Créteil,
service de gastroentérologie,
51 Avenue du Maréchal de Lattre de Tassigny,
94010 Créteil,
France
* Tirés à part

Iatrogenic colonic perforation is one of the most feared complications by gastroenterologists performing endoscopy. With an incidence estimated between 4.5 and 9.7 per 10.000 procedures and a mortality between 0 and 25%, endoscopic perforation is a rare but serious complication.

Management of colonic perforation is complex and involves a close medical-surgical cooperation. Development of laparoscopic surgery and endoscopic suturing techniques have significantly changed the management of this complication. Nevertheless, there is no consensual attitude as situations vary from case to case.

This review aims at precising the role of the surgeon in the management of endoscopic perforations and to expose different surgical strategies, from the wait and see approach to the laparotomy in emergency with fecal diversion.