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Endoscopic retrograde cholangiopancreatography in infants and children
1Department of Internal Medicine, Charles University Prague-Motol, Czech Republic.
Insights
Therapeutic endoscopic retrograde cholangiopancreatography (ERCP) is safe and effective in pediatric patients. This study shows successful application of diagnostic and therapeutic ERCP in children with various pancreatic and biliary conditions.
Area of Science:
- Pediatric Gastroenterology
- Interventional Endoscopy
Background:
- Limited data exists on therapeutic endoscopic retrograde cholangiopancreatography (ERCP) in pediatric patients.
- Previous reports primarily focus on diagnostic ERCP in children.
Purpose of the Study:
- To evaluate the safety and efficacy of therapeutic ERCP in pediatric patients.
- To assess the application of ERCP in managing biliary and pancreatic diseases in children.
Main Methods:
- Retrospective analysis of 80 ERCP procedures performed in 59 children over 4 years.
- Indications included obstructive jaundice, biliary atresia, recurrent pancreatitis, and abdominal trauma.
- Cannulation success rate and therapeutic interventions (sphincterotomy, stenting) were recorded.
Main Results:
- Successful duct cannulation in 94% of cases.
- Therapeutic interventions included common bile duct sphincterotomy (35 patients) and biliary stenting (16 patients).
- Complications were generally mild, including pancreatitis and contrast leak; one case of cholangitis occurred.
Conclusions:
- Diagnostic and therapeutic ERCP are safe and effective in pediatric patients.
- ERCP offers a valuable treatment option for pediatric biliary and pancreatic diseases.
- Outcomes in children are comparable to those in adult populations.
Background:
Although many reports describe the use of diagnostic endoscopic retrograde cholangiopancreatography (ERCP) in children, few mention therapeutic application of this technique in pediatric patients with pancreatic or biliary disease.
Methods:
We report our 4-year experience of 80 ERCPs performed in 59 children for obstructive jaundice or cholestasis with dilatation of the biliary tree (32 children), biliary atresia (11), recurrent pancreatitis (8), and blunt trauma to the abdomen (8).
Results:
The patients' ages ranged from 5 weeks to 18 years. The appropriate duct was cannulated in 94% of cases. Common bile duct sphincterotomy was performed in 35 patients and pancreatic duct sphincterotomy in one. Multiple procedures were done in 16 patients where biliary stents were inserted; in one patient with chronic pancreatitis and pancreaticolithiasis, pancreatic stent was inserted. Four patients developed mild pancreatitis, one had moderate pancreatitis and one had leak of contrast, which was treated by administration of clear fluids orally for one day. One patient with benign stenosis of the hepatic duct developed cholangitis after migration of the stent into the bowel lumen.
Conclusion:
Diagnostic and therapeutic ERCP can be done as safely and effectively in pediatric patients as in adults.