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Endoscopic retrograde cholangiopancreatography in children and adolescents
Patrick R Pfau1, Gisela G Chelimsky, Margaret F Kinnard
1Division of Gastroenterology, University Hospitals of Cleveland, Case Western Reserve University School of Medicine, Cleveland, Ohio 44106-5066, USA.
Insights
Endoscopic retrograde cholangiopancreatography (ERCP) is safe and effective for pediatric pancreatobiliary disorders. This diagnostic and therapeutic tool successfully impacts management in children of all ages.
Area of Science:
- Pediatric Gastroenterology
- Interventional Endoscopy
Background:
- Endoscopic retrograde cholangiopancreatography (ERCP) is increasingly utilized in pediatric care for both diagnosis and treatment.
- Understanding its application across different pediatric age groups is crucial.
Purpose of the Study:
- To evaluate the indications, feasibility, safety, and impact on patient management of ERCP in pediatric patients.
- To compare outcomes between younger children and adolescents.
Main Methods:
- Retrospective review of 53 ERCP procedures in patients 18 years or younger over a 4-year period.
- Comparison of anesthetic choices, duodenoscope types, diagnostic findings, therapeutic interventions, and complication rates between children (0-12 years) and adolescents (13-18 years).
Main Results:
- ERCP demonstrated high success (94%) with a low complication rate (6%), affecting management in 73% of cases.
- Children were more likely to receive general anesthesia and undergo procedures with a pediatric duodenoscope compared to adolescents.
Conclusions:
- ERCP is a safe and effective diagnostic and therapeutic modality for pediatric pancreatobiliary disorders.
- The procedure directly influences patient management across all pediatric age groups.
Objectives:
Endoscopic retrograde cholangiopancreatography (ERCP) is becoming a more frequently used diagnostic and therapeutic tool in children. We sought to determine the indications, feasibility, safety, and effect on patient management of ERCP in pediatric patients of varying age.
Methods:
All ERCPs performed during a 4-year period in patients aged 18 years or less at an academic hospital were retrospectively reviewed. The indications, type of anesthesia administered, type of duodenoscope used, diagnostic findings, therapeutic interventions, complication rate, and effect on management were compared between children (age 0-12 years) and adolescents (age 13-18 years).
Results:
A total of 53 procedures were performed in 43 patients whose median age was 13.5 years. ERCP was successful in 50 of 53 cases (94%) with a complication rate of 6%. Endoscopic therapy was provided in 24 of 53 cases (45%). Compared with adolescents (n = 28), children (n = 25) were more likely to receive general anesthesia (96% vs. 29%; P < 0.001) and undergo ERCP with a pediatric duodenoscope (0% vs. 40%). ERCP affected management in 73% of cases, equally in both groups.
Conclusion:
ERCP is a successful and safe diagnostic and therapeutic modality in a variety of pancreatobiliary disorders that directly affects management in children of all ages.