Follow-up to duodenal perforation secondary to ERCP / Gallstones

Questions:
I can't get a straight answer about what follow-up procedures need to be performed after gallstones, pancreatitis, common bile duct and duodenum perforation secondary to an ERCP? The VA is not returning my calls and my abdominal pain has been steadily increasing for the last several days. Also, what are the long-term complications of the perforations and pancreatitis? Are adhesions the only concern? Are there any other ones that are possible?

Background:
I underwent an ERCP (1/28) a month after passing a gallstone (12/25). The stone caused pancreatitis with lipid counts approaching 11k. My doctor encouraged me to have my gallbladder out as soon as possible. He commented that a second gallstone and the resulting pancreatitis could be fatal. (Is this true?)

I underwent the ERCP and when I regained consciousness in recovery, the nurse was trying to get me to stop screaming. All I could say was, "why am I in so much pain?

[Kevin Pho, MD]

Certainly another opinion is needed if your current group of physicians are not giving satisfactory answers.

A repeat ultrasound would be a reasonable next test to evaluate whether there continues to be bile duct leakage.  Depending on whether there is damage, a repeat ERCP or percutaneous transhepatic cholangiography (PTC) can be considered.  Leaks can be repaited via stenting during the ERCP.  

In any case, I would suggest another surgical or GI opinion to evaluate your symptoms.  

I cannot answer whether you need your gallbladder to come out, or how long you need to continue your low-fat diet without being personally involved in your case.  

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Thanks,
Kevin, M.D.