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Efficacy of ERCP in infancy and childhood

K Reinshagen1, A Müldner, B Manegold

  • 1Kinderchirurgische Klinik, Fakultät für klinische Medizin Mannheim der Universität Heidelberg, Germany. Konrad.Reinshagen@kch.ma.uni-heidelberg.de

Klinische Padiatrie
|September 1, 2007
PubMed

Insights

Endoscopic retrograde cholangiopancreatography (ERCP) is effective and safe in children, with diagnostic success in 57% and therapeutic success rates similar to adults. Higher resolution imaging is key for diagnostic ERCP indications.

Area of Science:

  • Pediatric Gastroenterology
  • Interventional Endoscopy

Background:

  • Endoscopic retrograde cholangiopancreatography (ERCP) is a standard diagnostic and therapeutic procedure for adults and children.
  • ERCP carries inherent risks, necessitating careful evaluation of its role in pediatric patients.

Purpose of the Study:

  • To define the diagnostic and therapeutic roles of ERCP in children.
  • To assess the effectiveness and safety of ERCP in pediatric patients.

Main Methods:

  • Retrospective review of all ERCPs performed in patients aged 14 and under over a 10-year period.
  • Documentation of indications, diagnostic findings, therapeutic interventions, and outcomes.

Main Results:

  • 61 procedures were performed on 47 pediatric patients (median age 8.56 years).
  • ERCP achieved an 89% success rate with a 6% complication rate.
  • Diagnostic ERCP established pathological diagnoses in 57%; therapeutic ERCP outcomes were comparable or better than in adults.

Conclusions:

  • Diagnostic ERCP is indicated for morphologic biliary or pancreatic duct disorders requiring high-resolution imaging for therapeutic decisions.
  • ERCP is rarely indicated for diagnosis without prior abnormal imaging (ultrasound, MRI).
  • Therapeutic ERCP efficacy in children is similar or superior to adults, with outcomes dependent on the underlying disease.
Abstract

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