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Evaluation of endoscopic retrograde cholangiopancreatography in Turkish children
Gül Çirkin1, Mesut Akarsu2, Yesim Öztürk1
1Division of Pediatrics, Department of Pediatric Gastroenterology Hepatology and Nutrition, Dokuz Eylul University Faculty of Medicine, Izmir, Turkey.
Insights
Endoscopic retrograde cholangiopancreatography (ERCP) is safe and effective for pediatric patients, with high success rates for biliary tract issues and pancreatitis. Specialized equipment could further improve outcomes.
Area of Science:
- Gastroenterology
- Pediatric Endoscopy
Background:
- Evaluation of indications, efficacy, and safety of ERCP in pediatric patients.
- Study conducted at a single center in Turkey from 2017 to 2021.
Purpose of the Study:
- To assess the effectiveness and safety of ERCP in children.
- To identify common indications and complications of ERCP in pediatric cases.
Main Methods:
- Retrospective review of 65 ERCP procedures in 50 pediatric patients (age 1-18).
- Data collection included demographics, indications, procedural details, success rates, and complications.
- Procedures performed using therapeutic duodenoscopes under conscious sedation.
Main Results:
- Primary indications were choledocholithiasis (52.3%) and chronic pancreatitis (18.5%).
- Overall cannulation success rate was 92.3% with frequent need for interventions.
- Post-ERCP pancreatitis occurred in 6.1% of cases (moderate severity); no fatalities reported.
Conclusions:
- ERCP is effective and safe in pediatric patients, especially with collaborative care.
- Technical challenges exist due to lack of pediatric-specific equipment.
- Need for specialized pediatric ERCP equipment and centralized facilities in Turkey highlighted.
Background:
This study aimed to evaluate the indications, efficacy, and safety of endoscopic retrograde cholangiopancreatography (ERCP) in pediatric patients at a single center in Turkey between 2017 and 2021.
Methods:
A retrospective review was conducted on 50 children (mean age, 12.7 years; range, 1-18 years) who underwent 65 ERCP procedures. Data collected included patient demographics, indications for ERCP, procedural details, success rates, and complications. All procedures were performed using therapeutic duodenoscopes under conscious sedation administered by an anesthesiologist.
Results:
The primary indications for ERCP were biliary tract issues, including choledocholithiasis (52.3%) and chronic pancreatitis (18.5%). The overall cannulation success rate was 92.3%. Multiple therapeutic interventions, such as sphincterotomies and stent placements, were often required. The most common complication was post-ERCP pancreatitis, observed in 6.1% of cases, all of which were moderate. No fatalities or serious anesthesia-related adverse events were reported.
Conclusion:
ERCP is an effective and safe therapeutic procedure in pediatric patients when performed in collaboration with adult gastroenterologists, despite technical challenges such as the lack of pediatric-specific duodenoscopes. The findings highlight the need for specialized pediatric ERCP equipment and suggest that centralized ERCP facilities could enhance patient outcomes in Turkey.
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Assessment: