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[Endoscopic cholangiopancreatography (ERCP) in pediatric patients]
A Güitrón1, R Adalid, R Barinagarrementería
1Departamento de Endoscopía Digestiva, Hospital de Especialidades No. 71, Torreón, Coah., México.
Insights
Endoscopic Retrograde Cholangio-Pancreatography (ERCP) is a safe and effective procedure for diagnosing and treating pancreaticobiliary disorders in children. This study demonstrates its utility and safety in pediatric patients, highlighting its underuse in this population.
Area of Science:
- Pediatric Gastroenterology
- Interventional Endoscopy
Background:
- Endoscopic Retrograde Cholangio-Pancreatography (ERCP) is a standard procedure for adult pancreatobiliary diseases.
- Its application in pediatric populations remains limited.
Purpose of the Study:
- To assess the safety and efficacy of ERCP in diagnosing and treating pediatric pancreatobiliary disorders.
- To evaluate the utility of ERCP in children and adolescents.
Main Methods:
- Retrospective review of 72 ERCP procedures performed in 50 children (ages 7-17).
- Procedures utilized standard adult side-viewing duodenoscopes.
- General anesthesia or conscious sedation was employed.
Main Results:
- Successful cannulation of biliary or pancreatic ducts achieved in 98% of cases.
- Abnormalities detected in 54% of biliary ducts and 24% of pancreatic ducts.
- Therapeutic interventions included sphincterotomy (19 patients) and stent placement (15 patients).
- Complications were minimal (6%), primarily transient abdominal pain and elevated amylase.
Conclusions:
- ERCP is a safe and effective diagnostic and therapeutic tool for pediatric pancreatobiliary conditions.
- The procedure is underutilized in children and adolescents.
- ERCP offers significant benefits for managing complex cases in this age group.
Background:
While Endoscopic Retrograde Cholangio-Pancreatography (ERCP) is widely employed in the management of adult pancreaticobiliary disease, its use in children has been limited.
Aims:
To evaluate if ERCP diagnostic and therapeutic, is a safe and useful procedure in the diagnosis and treatment of pancreatobiliary disorders in children.
Patients, Methods And Results:
We reviewed our experience with 72 ERCPs performed in 50 children (age 7-17 y, mean 14.5 y). The procedures were performed using standard adult side-viewing duodenoscopes. We used general anesthesia in 25 and conscious sedation in 47. In 38 patients we performed one, in 7/2, in 2/3, in 1/4 and in 2/5 ERCPs. The biliary or pancreatic ducts were successfully cannulated in 98%. Abnormal papilla accounted for the unsuccessful attempt. Abnormalities were found in biliary ducts in 54% and pancreatic duct in 24%, including choledocholithiasis (10), stenosis of the papilla (5), benign biliary stenoses (5), recurrent pancreatitis (4), pancreatic fistula (4), bile duct leak (3), cholelithiasis (3), chronic calcifying pancreatitis (2), pancreas divisum (2) and choledochal cyst (1). Endoscopic sphincterotomy was performed in 19 patients, 15 on biliary segment and four on pancreatic segment. Stents were placed in the biliary duct in nine patients and in pancreatic duct in six patients. Complications included abdominal pain and elevated amylase in three patients (6%), which resolved rapidly.
Conclusions:
ERCP in children and adolescents is a safe and underutilized diagnostic and therapeutic procedure.