Endoscopic Retrograde Cholangiopancreatography in Children and Adolescents

• Published in: Journal of pediatric gastroenterology and nutrition Vol. 35; no. 5; pp. 619 - 623
• Main Authors: Pfau, Patrick R., Chelimsky, Gisela G., Kinnard, Margaret F., Sivak, Michael V., Wong, Richard C. K., Isenberg, Gerard A., Gurumurthy, Priya, Chak, Amitabh
• Format: Journal Article
• Language: English
• Published: Hagerstown, MD Lippincott Williams & Wilkins, Inc 01-11-2002; Lippincott
• Subjects: Adolescent; Anesthesia, General; Biliary disease; Biliary Tract Diseases - diagnosis; Biliary Tract Diseases - therapy; Biological and medical sciences; Child; Child, Preschool; Cholangiopancreatography, Endoscopic Retrograde - methods; Complications; Diagnosis, Differential; Digestive system; Duodenoscopes; Endoscopic retrograde cholangiopancreatogram; Female; Humans; Infant; Investigative techniques, diagnostic techniques (general aspects); Male; Medical sciences; Pancreatic Diseases - diagnosis; Pancreatic Diseases - therapy; Pancreatitis; Postoperative Complications; Radiodiagnosis. Nmr imagery. Nmr spectrometry; Retrospective Studies; Safety; Therapy; Treatment Outcome; Human; Cholangiopancreatography; Radiodiagnosis; Indication; Retrograde; Biliary tract disease; Treatment; Endoscopic approach; Endoscopic retrograde cholangiopancreatogram-Pancreatitis-Biliary disease-Therapy- Complications; Instrument; Digestive diseases; Complication; Feasibility; Endoscopy; Diagnosis; Safety; Child; Pancreatic disease
• ISSN: 0277-2116; 1536-4801
• DOI: 10.1002/j.1536-4801.2002.tb07917.x

ABSTRACT
Objectives
Endoscopic retrograde cholangiopancreatography (ERCP) is becoming a more frequently used diagnostic and therapeutic tool in children. We sought to determine the indications, feasibility, safety, and effect on patient management of ERCP in pediatric patients of varying age.
Methods
All ERCPs performed during a 4‐year period in patients aged 18 years or less at an academic hospital were retrospectively reviewed. The indications, type of anesthesia administered, type of duodenoscope used, diagnostic findings, therapeutic interventions, complication rate, and effect on management were compared between children (age 0–12 years) and adolescents (age 13–18 years).
Results
A total of 53 procedures were performed in 43 patients whose median age was 13.5 years. ERCP was successful in 50 of 53 cases (94%) with a complication rate of 6%. Endoscopic therapy was provided in 24 of 53 cases (45%). Compared with adolescents (n = 28), children (n = 25) were more likely to receive general anesthesia (96% vs. 29%;P < 0.001) and undergo ERCP with a pediatric duodenoscope (0% vs. 40%). ERCP affected management in 73% of cases, equally in both groups.
Conclusion
ERCP is a successful and safe diagnostic and therapeutic modality in a variety of pancreatobiliary disorders that directly affects management in children of all ages.