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Endoscopic Retrograde Cholangiopancreatography in Pediatric Population: A Decade-Long Experience from 2 Tertiary
Ersin Batıbay1, Osman Yüksekyayla1, Mahmut Polat2
1Department of Gastroenterology, Harran University Faculty of Medicine, Şanlıurfa, Türkiye.
Insights
Endoscopic retrograde cholangiopancreatography (ERCP) is safe and effective for pediatric patients with pancreato-biliary disorders. This study demonstrates high success rates and minimal complications in children undergoing ERCP for conditions like common bile duct stones.
Area of Science:
- Pediatric Gastroenterology
- Interventional Endoscopy
- Hepatobiliary Medicine
Background:
- Endoscopic retrograde cholangiopancreatography (ERCP) is crucial for adult pancreato-biliary disorders.
- Its application in pediatric populations is less established.
- This study addresses the limited data on ERCP in children.
Purpose of the Study:
- To evaluate the indications for ERCP in pediatric patients.
- To assess the technical success rates of ERCP in children.
- To determine the safety and complication profile of ERCP in pediatric cases.
Main Methods:
- Retrospective analysis of ERCP procedures in patients under 18 years.
- Data collected from two tertiary centers in Türkiye (January 2013 - May 2024).
- Review of medical records for indications, procedures, and outcomes.
Main Results:
- 153 ERCPs performed on 83 pediatric patients (mean age 12.9 years).
- Common indications: bile duct stones (47%) and hydatid cyst complications (29%).
- High cannulation success (98.7%), stone extraction (30%), stent placement (25%), with low rates of mild pancreatitis (4.8%) and cholangitis (12%). No mortality.
Conclusions:
- ERCP is an effective and safe therapeutic option for pediatric pancreato-biliary disorders.
- The procedure demonstrates a favorable safety profile in children.
- Supports expanded use of ERCP in pediatric gastroenterology.
Background/Aims:
Endoscopic retrograde cholangiopancreatography (ERCP) is an essential diagnostic and therapeutic method for pancreato-biliary disorders in adults, but its use in pediatric populations remains limited. This study aims to evaluate the indications, technical success, and safety of ERCP in pediatric patients.
Materials And Methods:
A retrospective analysis of all ERCP procedures performed on patients under 18 years of age was conducted at 2 tertiary centers in Türkiye (Harran University and Gaziantep University Hospital) during the period between January 2013 and May 2024. The data used for the study were obtained from patients' medical records.
Results:
A total of 153 ERCP procedures were performed on 83 pediatric patients (64%, female) with a mean age of 12.9 years (range 3-17) at the time of ERCP. Common bile duct stones were the most frequent indication (n = 39, 47%) for ERCP, followed by biliary hydatid cyst-related complications (n = 24, 29%). The overall cannulation success rate was 98.7% (82/83). Endoscopic sphincterotomy was performed in 79 (95%) patients. More than one ERCP procedure was performed in 41 (49%) patients. Stones were extracted in 32 patients (30 were biliary and 2 pancreatic). Stent placement was performed in 33 patients (25 biliary and 8 pancreatic). Post-ERCP pancreatitis developed in 4.8% (n = 4) of patients, and all classified as mild. Ten (12%) patients developed mild/moderate cholangitis following ERCP. One patient (1.2%) experienced minor bleeding. About half of the patients (48%) were discharged within 1 day postprocedure. No patient experienced procedure-related mortality.
Conclusion:
Our study results indicate that ERCP is both effective and safe in the pediatric population.
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