The aim of this study was to analyze the location, the cause and treatment of iatrogenic gastrointestinal perforations following therapeutic endoscopic procedures. Perforation occurred in 12 patients out of 3,389, giving cases occurred intraoperatively or postoperatively. Among them, 6 cases were closed by titanium clipping and 1 case by purse string suture. In another case after cap-assisted endoscopic mucosal resection (EMRC), attempted titanium clipping failed, emergency surgery had to be performed. One each case, after Argon plasma coagulation (APC) and case after endoscopic piecemeal mucosal resection (EPMR), recovered well spontaneously. In two cases, titanium clips fell off endoscopic mucosal resection (EMR) resulting in delayed perforation, required surgery. Key factors for preventing and managing the perforation of endoscopic treatment, include the choice of endoscopic approach, processing method of perforation, detail processing in endoscopic therapy, proficient degree of operators and psychological quality.
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