Related Experiment Videos
Therapeutic ERCP in paediatric patients
R Rocca1, F Castellino, M Daperno
1Gastroenterology Unit, Ospedale Mauriziano 'Umberto I', Largo Turati 62, 10128 Turin, Italy. apera@mauriziano.it
Insights
Endoscopic retrograde cholangiopancreatography (ERCP) is safe and effective for diagnosing and treating pediatric biliopancreatic diseases. This procedure shows similar outcomes and complications to those seen in adult patients.
Area of Science:
- Gastroenterology
- Pediatric Endoscopy
- Biliopancreatic Diseases
Background:
- Pediatric biliopancreatic diseases are rare, posing challenges for endoscopic retrograde cholangiopancreatography (ERCP).
- Equipment size and the rise of MR-cholangiopancreatography impact ERCP's role in children.
- This study assesses ERCP's utility in pediatric biliopancreatic conditions.
Purpose of the Study:
- To evaluate the diagnostic yield of ERCP in children with suspected pancreatic or biliary tract disease.
- To assess the therapeutic efficacy of ERCP in managing pediatric biliopancreatic disorders.
- To compare ERCP indications, techniques, and complications in children versus adults.
Main Methods:
- Retrospective analysis of 48 ERCP procedures in 38 children (4 weeks to 17 years) from 1996-2002.
- Procedures performed under general anesthesia using pediatric or standard duodenoscopes based on age.
- Evaluation of diagnostic and therapeutic interventions for various biliopancreatic conditions.
Main Results:
- Successful cannulation in 37 out of 38 patients.
- Common indications included choledocholithiasis (14), biliopancreatic abnormalities (8), and pancreatitis (8).
- Therapeutic interventions like sphincterotomy, stone extraction, or stenting were performed in 30 patients with mild, conservatively treated complications.
Conclusions:
- Diagnostic and therapeutic ERCP is a safe and effective management tool for pediatric biliopancreatic diseases.
- ERCP in children demonstrates comparable indications, techniques, and complication profiles to adult populations.
- ERCP remains a valuable option for managing complex biliopancreatic issues in pediatric patients.
Background:
Major limitations of endoscopic retrograde cholangiopancreatography in paediatric populations are a low incidence of biliopancreatic disease among children, the equipment dimensions (size of endoscopes and devices) and the increasing role of MR-cholangiopancreatography in the field of diagnostic indications. Aim of this study was to evaluate the diagnostic and therapeutic yields of endoscopic retrograde cholangiopancreatography for biliopancreatic diseases in a paediatric population.
Methods:
Between 1996 and 2002, 48 endoscopic retrograde cholangiopancreatographies were performed in 38 children aged 4 weeks to 17 years as part of the diagnostic evaluation for suspected pancreatic or biliary tract disease. Endoscopic retrograde cholangiopancreatography was carried out under general anaesthesia, using prototype paediatric duodenoscopes or standard duodenoscopes in children younger or older than 18 months, respectively.
Results:
The indications to perform endoscopic retrograde cholangiopancreatography were common bile duct stones (14 children), biliopancreatic abnormalities (8), primary sclerosing cholangitis (2), Wirsung disruption (1), biliary leakage (1), cholestasis (4) and pancreatitis (8). Cannulation was successful in all patients but one. Sphincterotomy together with stone extraction or stent insertion was performed in 30/38 patients. Immediate complications were mild and treated conservatively.
Conclusions:
Diagnostic and therapeutic endoscopic retrograde cholangiopancreatography can be used safely and effectively in the management of biliopancreatic diseases in childhood as well. Indications, endoscopic techniques and complications are similar to those reported for adult patients.
