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Updated: Nov 22, 2025

Endoscopic Ultrasound-Guided Biliary Drainage: Endoscopic Ultrasound-Guided Hepaticogastrostomy in Malignant Biliary Obstruction
Published on: March 25, 2022
Endoscopic retrograde cholangiopancreatography and endoscopic ultrasound in children
Manabu Tagawa1, Atsushi Morita1, Kazuo Imagawa1
1Department of Child Health, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan.
Insights
Pediatric gastroenterology utilizes endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic ultrasound (EUS) for diagnosing and treating hepatobiliary and pancreatic diseases. This review details current pediatric applications, including specialized equipment, anesthesia, radiation, indications, and training for these essential endoscopic procedures.
Area of Science:
- Pediatric Gastroenterology
- Gastrointestinal Endoscopy
Background:
- Gastrointestinal endoscopy is crucial for pediatric gastroenterology.
- Endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic ultrasound (EUS) are established procedures for hepatobiliary and pancreatic diseases.
- Guidelines now define the roles of ERCP and EUS in pediatric care.
Purpose of the Study:
- To review the current status of ERCP and EUS in pediatric patients.
- To highlight the distinctions between pediatric and adult endoscopy practices.
- To discuss future developments in pediatric endoscopy.
Main Methods:
- Review of current literature and practice guidelines.
- Focus on pediatric-specific aspects of ERCP and EUS.
- Analysis of equipment, anesthesia, radiation, indications, and training.
Main Results:
- Discussion of specialized endoscopes for pediatric use.
- Consideration of general anesthesia and radiation exposure in children.
- Overview of biliary and pancreatic indications for pediatric ERCP and EUS.
- Emphasis on education and training requirements for pediatric endoscopists.
- Exploration of future expectations for pediatric endoscope development.
Conclusions:
- ERCP and EUS are vital tools in pediatric gastroenterology.
- Pediatric endoscopy requires specialized approaches distinct from adult practices.
- Continued development and training are essential for advancing pediatric endoscopic procedures.
Abstract:
Gastrointestinal endoscopy is fundamental to diagnostic and therapeutic procedures in pediatric gastroenterology. In the decades since endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic ultrasound (EUS) for hepatobiliary and pancreatic disease were introduced into clinical practice, there has been increasing interest in these procedures, and practice guidelines and position papers that clearly define the role of ERCP and EUS in children have been published. Based on the distinction of endoscopy between children and adults, this review focuses on the current state of ERCP and EUS procedures in children, including the types of endoscopes used in children, general anesthesia and radiation exposure, biliary and pancreatic indications, considerations of education and training for ERCP and EUS procedures in children, and expectations for development of endoscopes for children.
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