The article presents the clinical experiences of the physicians of the endoscopic Department to implement ERCP in the period 2014-2016. Analyzed the errors, causes, treatment results of patients with retroduodenal perforations after EPST when performing ERCP.

This article describes a rare clinical case of complications after ERCP is the development of extensive subcapsular hematoma of the right lobe of the liver. Presented to the international medical statistics on this rare complication.The described methods of diagnosis and treatment of this rare iatrogenic surgical pathology.

Submucosal tunneling endoscopic resection (STER) is a comparatively new method of treatment of submucosal masses of the upper gastrointestinal tract. According to the world literature, complications of these operations are relatively rare and primarily associated with development of pneumothorax, pneumoperitoneum, and subcutaneous emphysema. These problems are directly related to the technique of manipulation and predictable. In our practice we had a complication that developed in a 60 years old female, during removal 30 mm size submucosal gastric tumor (schwannoma) by STER technic. During the formation of the tunnel, the covering mucosa was ruptured. It was closed by endoscopic clipping. During the extraction of the resected tumor the fullthickness rupture of the upper part of esophagus and hypopharynx had occurred. The attempts of endoscopic suturing of the defect were unsuccessful and the open surgery was applied. The patient was discharged from the hospital in good health at the 21th day after the operation. In the publications on this topic, submucosal tunneling endoscopic resection of submucosal lesions of the upper gastrointestinal tract is quite a safe procedure. However, in view of its relative novelty and no large international experience, it is not always possible to foresee all possible difficulties. Therefore, these operations must be performed in a hospital with ample opportunities to deal with unforeseen complications.

Duodenal adenomas are relatively uncommon neoplasms in the general population. They are traditionally treated surgically but with a high injury and mortality rate. Endoscopic methods are increasingly being used for treatment of epithelial tumors of the duodenum. Despite an extensive use of the endoscopic submucosal dissection in esophagus, stomach and colon, the implementation of this treatment in duodenum is significantly less spread because of often arising complications. However this method significantly reduces the relapse rate associated with piecemeal endoscopic resection. In a clinical case study we show complication in a 72 year old patient after the resection of a duodenal adenoma using endoscopic submucosal dissection method. On the first day after the procedure necrosis occurs in place where the dissection was. The perforation zone which was situated on the wall opposite to major duodenal papilla and occupied the half of intestine circumference was removed by formation of duodenojejunum anastomosis. On the 12-th day after this emergency surgery the patient was released in satisfactory condition. The perforation rate after endoscopic submucosal dissection in duodenum reaches 50%. An endoscopic method can be used for treatment of neoplasms in duodenum but patient should be well informed of risks and complications after this manipulation. Therefore, surgeons and endoscopists should cooperate closely in case of complications.