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Endoscopic retrograde cholangiopancreatography in paediatric patients with biliary disorders
K Ashida1, A Nagita, M Sakaguchi
1Second Department of Internal Medicine, Osaka Medical College, Japan.
Insights
Endoscopic retrograde cholangiopancreatography (ERCP) is a safe and effective diagnostic tool for pediatric biliary disorders. This study shows ERCP provides crucial information for diagnosing conditions in children.
Area of Science:
- Pediatric Gastroenterology
- Diagnostic Endoscopy
- Hepatobiliary Imaging
Background:
- Endoscopic retrograde cholangiopancreatography (ERCP) is utilized in pediatric care.
- The diagnostic utility of ERCP in pediatric biliary disorders requires further documentation.
Purpose of the Study:
- To evaluate the effectiveness and safety of ERCP in pediatric patients with biliary disorders.
- To assess ERCP's role in differential diagnosis and detailed pancreaticobiliary system evaluation.
Main Methods:
- Retrospective analysis of 32 ERCP sessions in 29 pediatric patients (1 month to 15 years).
- Evaluation of diagnostic success, cannulation rates, and opacification of biliary tracts.
- Assessment of ERCP's role in specific diagnoses like neonatal hepatitis, extrahepatic biliary atresia, and choledochal cysts.
Main Results:
- Successful cannulation in all patients.
- Biliary tract opacification achieved in most patients, with exceptions in extrahepatic biliary atresia.
- ERCP successfully differentiated neonatal hepatitis from extrahepatic biliary atresia.
- Confirmed diagnosis of anomalous pancreaticobiliary ductal system with choledochal cyst.
- Provided detailed pancreaticobiliary information in other pediatric cases.
- No adverse events reported during procedures.
Conclusions:
- ERCP is a valuable and safe endoscopic technique for diagnosing pediatric biliary disorders.
- The procedure offers crucial diagnostic information when confirmed diagnosis or detailed insights are needed in children.
- ERCP aids in differential diagnosis and characterization of complex pancreaticobiliary anomalies in pediatric patients.
Abstract:
Endoscopic retrograde cholangiopancreatography (ERCP) has long been used in children. The usefulness of ERCP in paediatric patients with various biliary disorders, however, has not been well documented. Thirty-two sessions of ERCP performed in 29 paediatric patients ranging in age from 1 month to 15 years were evaluated. Endoscopic retrograde cholangiopancreatography was to confirm diagnosis or to obtain detailed information about their pancreaticobiliary system. Cannulation was successful in all patients. Opacification of the biliary tracts was also successful in all except for three patients with extrahepatic biliary atresia. Endoscopic retrograde cholangiopancreatography was assessed to be successful in making a differential diagnosis of neonatal hepatitis from extrahepatic biliary atresia, and in having a confirmed diagnosis of anomalous arrangement of the pancreaticobiliary ductal system associated with choledochal cyst. The procedure was also useful for obtaining detailed information on the pancreaticobiliary system in the other children. No accidents occurred during the endoscopic procedures in any of the paediatric patients. When a confirmed diagnosis or detailed information is needed in paediatric patients with biliary disorders, ERCP is a useful and safe technique.