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Pediatric ERCP: Factors for Success and Complication-A 17-Year, Multisite Experience.
Eric Lorio1, Chris Moreau2, Brian Hernandez3
1From Department of Gastroenterology and Hepatology, Tulane University School of Medicine, New Orleans, LA.
Journal of Pediatric Gastroenterology and Nutrition
|July 3, 2023
Summary
Pediatric endoscopic retrograde cholangiopancreatography (ERCP) has a 12.7% adverse event rate, higher than adults. Younger age and pancreatic duct interventions increase risks, necessitating tailored pediatric strategies.
Area of Science:
- Pediatric Gastroenterology
- Interventional Endoscopy
Background:
- Endoscopic retrograde cholangiopancreatography (ERCP) utilization is increasing in pediatric patients.
- Lack of pediatric-specific research necessitates extrapolation of adult data for risk factors and prevention.
Purpose of the Study:
- Identify risks for adverse events, procedure failure, and prolonged courses in pediatric ERCP.
- Evaluate applicability of adult complexity grading systems to pediatric patients.
Main Methods:
- Retrospective, multisite study of pediatric ERCP cases (January 2004 - January 2021).
- Data collected via electronic medical records; adverse events defined by consensus criteria.
Main Results:
- 287 children underwent 716 ERCPs with a 95.5% success rate and 12.7% adverse event rate.
- Younger age, increased case complexity, and pancreatic duct interventions (stent removal, pancreatic stenting) correlated with higher adverse events and repeat procedures.
- Conditions like pancreatitis and pancreatic divisum increased adverse events and repeat ERCP rates.
Conclusions:
- Pediatric ERCP adverse event rates exceed adult rates.
- Adult complexity grading systems show applicability in pediatric ERCP.
- Young age and pancreatic duct interventions are key risk factors for adverse outcomes in pediatric ERCP.
