RETRODUODENAL PAPILLARY PERFORATION AFTER ENDOSCOPIE SPHINCTEROTOMY -CONTRIBUTION OF SURGICAL CURE BY DUODENAL EXCLUSION - A REPORT OF 3 CASES

Among the complications of endoscopic sphincterotomy whose rate is abo ut 10 % of cases, the retroduodenal papillary perforation represents a bout 1 % of cases. The diagnosis lies on radiological examination whic h may show during the sphincterotomy the extravasation of the contrast fluid used for the retrograde cholangiography; it can be suggested by the presence of clinical signs of retroperitoneal sepsis or peritonit is. The treatment depends on the severity of the clinical symptomatolo gy; it is generally a medical treatment associating nasogastric aspira tion and antibiotherapy, and more rarely a surgical one. There is no c onsensus concerning surgical modalities. We report 3 cases of retroduo denal papillary perforation treated surgical by a duodenal exclusion a iming to transform a complex fistula in a bilio-pancreatic fistula whi ch can be more easily managed by somatostatine-like drugs.