{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T03:00:55Z","timestamp":1789182055459,"version":"build-2803163510"},"reference-count":10,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2021,7,2]],"date-time":"2021-07-02T00:00:00Z","timestamp":1625184000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["JGH Open"],"published-print":{"date-parts":[[2021,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>As a diagnostic and therapeutic treatment role on malignant biliary obstruction, endoscopic retrograde cholangiopancreatography (ERCP) has already been used as a routine procedure, especially for palliative treatment on advanced stage peri\u2010ampullary tumor. This minimal invasive procedure has many early or late complications such as bleeding, post\u2010ERCP pancreatitis, perforation, cholangitis, and the rare duodenal perforation from the stent migration. The current review reported the incidence of stent erosion associated with duodenal perforation was only 1% for this palliative procedure. We report a 75\u2009years old male patient with diffuse abdominal tenderness 7\u2009days after palliative ERCP stent placement for malignant biliary obstruction, metal stent could not be placed, and plastic stent placement had been done. There was no post\u2010ERCP pancreatitis found during the first 24\u2009h. The patient came to the emergency with clinical sign and symptoms of diffuse peritonitis; abdominal X\u2010ray found no free intraperitoneal air. Exploratory laparotomy was performed, and we found bile leak from the third part of perforated duodenal with 5\u2009mm in diameter, plastic stent exposed from the perforation site, and no active bleeding. We performed primary suture of the duodenum, cholecysto\u2010enteric bypass, pyloric exclusion, gastro\u2010jejunostomy bypass, and braun anastomosis. Jejunostomy feeding has been placed. There were no postoperative cardiopulmonary complication, and the patient could tolerate well for oral intake and discharged from hospital at 10th postoperative day (POD). This rare duodenal perforation complication could happen even in plastic stent placement during the ERCP procedure, and early management was needed to gain the favorable outcome.<\/jats:p>","DOI":"10.1002\/jgh3.12608","type":"journal-article","created":{"date-parts":[[2021,7,2]],"date-time":"2021-07-02T12:15:56Z","timestamp":1625228156000},"page":"968-970","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["A rare clinical presentation of third part duodenal perforation due to post\u2010endoscopic retrograde cholangiopancreatography stent migration on advanced stage peri\u2010ampullary tumor"],"prefix":"10.1002","volume":"5","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0310-7415","authenticated-orcid":false,"given":"Budhi","family":"Ida Bagus","sequence":"first","affiliation":[{"name":"Department of Surgery Sebelas Maret University  Surakarta Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,7,2]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.giec.2014.09.006"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.surge.2017.05.004"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2015.09.039"},{"key":"e_1_2_5_5_1","first-page":"18","article-title":"Management of duodenal perforation post\u2010endoscopic retrograde cholangiopancreatography. When and whom to operate and what factors determine the outcome? 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