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Endoscopic treatments for complicated biliary disease in children

Nicholas Norris1, David S Vitale2

  • 1Department of Pediatric Gastroenterology, Cedars Sinai Medical Center, Los Angeles, CA, USA.

Seminars in Pediatric Surgery
|July 10, 2025
PubMed

Insights

Pediatric endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic ultrasound (EUS) are increasingly used for biliary disease. This review covers current endoscopic treatments and challenges for children, emphasizing the need for specialized equipment and care.

Area of Science:

  • Gastroenterology
  • Pediatric Endoscopy
  • Biliary Tract Diseases

Background:

  • Endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic ultrasound (EUS) are vital for managing biliary disease.
  • Their use in pediatric patients is rising due to increased gallstone disease in children.
  • Pediatric-specific advanced endoscopic care access is crucial.

Purpose of the Study:

  • To review endoscopic treatment options for pediatric biliary disease.
  • To discuss recent literature on ERCP and EUS in children.
  • To provide approaches for complex pediatric biliary conditions.

Main Methods:

  • Review of current literature on pediatric ERCP and EUS.
  • Analysis of multi-center collaboration data on safety and efficacy.
  • Discussion of diagnostic and emerging therapeutic applications of EUS.

Main Results:

  • Multi-center studies confirm ERCP's safety and efficacy in pediatric patients.
  • EUS is primarily diagnostic for pediatric biliary pathology but evolving therapeutically.
  • Limited access to pediatric-specific endoscopic equipment is a significant challenge.

Conclusions:

  • There is a growing need for advanced endoscopic care tailored to pediatric biliary disease.
  • Further development and access to pediatric-specific endoscopic equipment are essential.
  • This review offers insights into managing complex biliary diseases in children using endoscopic modalities.

Keywords:
Advanced endoscopyBiliary pancreatitisCholedocholithiasisERCPEUSInterventional endoscopy

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