Safety and efficacy of ERCP using standard duodenoscopes in pediatric patients with choledocholithiasis: A...

This study aimed to evaluate the safety and efficacy of endoscopic retrograde cholangiopancreatography (ERCP) in children aged 2 to 13 years with choledocholithiasis, addressing the challenges of using standard adult duodenoscopes in a pediatric population. Materials and Methods: We retrospectively reviewed the medical records of 107 patients who underwent ERCP at a single tertiary ERCP center between 2014 and 2024. Among these, patients with chronic pancreatitis or biliary strictures were excluded, resulting in a final cohort of 70 pediatric patients. A control group of 397 adult patients with similar conditions was analyzed for comparison. Procedural success was defined as successful deep cannulation of the common bile duct and stone extraction. The pediatric group achieved a procedural success rate of 91.4%, compared to 95.2% in adults, with no statistically significant difference (P = .278). Complication rates were low and similar between groups: bleeding occurred in 8.6% of pediatric patients, while pancreatitis was noted in 1.4%. No mortalities were reported in the pediatric cohort. The findings indicate that ERCP can be performed safely and effectively in children using standard adult duodenoscopes by experienced adult gastroenterologists under proper supervision. The procedural success rates and complication rates were comparable to adults, suggesting that ERCP is a viable option for pediatric choledocholithiasis. To optimize outcomes, further multicenter studies and improved pediatric training are recommended.