Endoscopic Retrograd Colangiopancreatography in Children: A Single Center Experience
PDF
Cite
Share
Request
Original Article
P: 373-378
December 2021

Endoscopic Retrograd Colangiopancreatography in Children: A Single Center Experience

J Curr Pediatr 2021;19(3):373-378
1. Hacettepe Üniversitesi Tıp Fakültesi, Çocuk Gastroenteroloji Bilim Dalı, Ankara, Türkiye
2. Hacettepe Üniversitesi Tıp Fakültesi, Gastroenteroloji Bilim Dalı, Ankara, Türkiye
No information available.
No information available
Received Date: 06.07.2021
Accepted Date: 28.09.2021
Publish Date: 24.12.2021
PDF
Cite
Share
Request

ABSTRACT

Introduction:

Endoscopic retrograde cholangiopancreatography (ERCP) is a procedure that uses endoscopy and fluroscopy together to provide diagnosis and treatment in pancreatic and biliary tract diseases.

Materials and Methods:

The data of 46 pediatric patients who underwent ERCP between November 2017 - April 2020 at Hacettepe University Gastroenterology Endoscopy Unit were retrospectively analyzed.

Results:

A total of 77 (1-5) ERCP procedures were performed in 46 patients (29 F, 63.04%), 23 with biliary and 23 with pancreatic indications. The mean age was 10.3±4.07 (2.08 -17) years. The smallest patient was 12.6 kg. ERCP indications; suspicion of common bile duct stones in 16 patients (34.8%), chronic pancreatitis (CP) and pain in 9 patients (19.6%), recurrent acute pancreatitis attacks in 8 patients (RAP, 8.7%), CP and RAP in 4 patients (%) 8.7), liver transplantation and cholestasis in 3 patients (6.5%), benign biliary stenosis (BBS) in 2 patients (4.3%) and 1 patient for excluding the disease due to jaundice (2.2%), prophylactic treatment in 1 patient pancreatic stenting (2.2%), biliary tract-related hydatid cyst (2.2%) in 1 patient and pancreatic fistula in 1 patient (2.2%). In ERCP, 14 (30.4%) CP, 7 (15.2%) choledochal cysts, 11 (23.9%) common choledochal stones, 4 (8.7%) sphincter dysfunction of Oddi, 3 (6.5%) BBS, 3 (6.5%) anastomotic stenosis, 1 (2.2%) pancreatic fistula, 1 (2.2%) biliary tract-related hydatid cyst were diagnosed. Abnormal pancreaticobiliary junction was detected in 6 (13%) patients and pancreatic divisium was detected in 5 (10.9%) patients. Endoscopic sphincterotomy was performed in 37 (80.4%) patients, and dilatation was performed in 10 (21.7%) patients. Stones were removed in 22 (47.8%) and stent was placed on 27 (58.6%). There were no major complications such as pancreatitis, bleeding or perforation.

Conclusion:

If ERCP is performed by experienced people in the pediatric age group, it is a very reliable and effective diagnosis and treatment method in children.

References

1Nathan D, Egbert ND, Bloom DA, Dillman JR. Magnetic resonance imaging of the pediatric pancreaticobiliary system. Magnetic resonance imaging clinics of North America 2013: 21:681-96.
2McCune WS, Shorb PE, Moscovitz H (1968) Endoscopic cannulation of the ampulla of Vater: a preliminary report. Ann Surg 1968:167:752-6 .
3Waye JD. Endoscopic retrograde cholangiopancreatography in the infant. Am J Gastroenterol 1976;65:461-3.
4Cohen S, Bacon BR, Berlin JA, Fleischer D, Hecht GA, Loehrer PJ Sr, et al. National Institutes of Health State-of-the-Science Conference Statement: ERCP for diagnosis and therapy, January 14-16, 2002. Gastrointest Endosc 2002;56:803-9.
5ASGE Technology Committee, Barth BA, Banerjee S, Bhat YM, Desilets DJ, Gottlieb KT, Maple JT, et al. Equipment for pediatric endoscopy. Gastrointest Endosc 2012;76:8-17.
6Guelrud M, Jaen D, Torres P, Mujica C, Mendoza S, Rivero E, et al. Endoscopic cholangiopancreatography in the infant: evaluation of a new prototype pediatric duodenoscope. Gastrointest Endosc 1987;33:4-8.
7Giefer MJ, Kozarek R A. Technical outcomes and complications of pediatric ERCP. Surgical Endoscopy 2015:29:3543-50.
8Patai A, Solymosi N, Mohacsi L, Patai A. V. Indomethacin and diclofenac in the prevention of post-ERCP pancreatitis: a systematic review and meta-analysis of prospective controlled trials. Gastrointest Endosc 2017;85:1144-56.
9Park C-H, Paik W.H, Park E.T, Shim C.S, Lee T.Y, Kang C, et al. Aggressive intravenous hydration with lactated Ringer’s solution for prevention of post-ERCP pancreatitis: a prospective randomized multicenter clinical trial. Endoscopy 2018;50:378-85.
10Rabenstein T, Schneider HT, Nicklas M, Ruppert T, Katalinic A, Hahn EG, et al. Impact of skill and experience of the endoscopist on the outcome of endoscopic sphincterotomy techniques. Gastrointest Endosc 1999;50:628-36.
11Thomson M, Tringali A, Dumonceau JM, Tavares M, Tabbers MM, Furlano R,et al. Paediatric Gastrointestinal Endoscopy: European Society for Paediatric Gastroenterology Hepatology and Nutrition of Gastrointestinal Endoscopy Guidelines. J Pediatr Gastroenterol Nutr 2017;64:133-53.
12Shanmugam N.P, Harrison P.M, Devlin J, Peddu P, Knisely A.S, Davenport M, et al. Selective Use of Endoscopic Retrograde Cholangiopancreatography in the Diagnosis of Biliary Atresia in Infants Younger Than 100 Days. J Pediatr Gastroenterol Nutr 2009;49:435-41.
13Keil R, Drábek J, Lochmannová J, Šťovíček J, Koptová P, Wasserbauer M, et al. ERCP in infants, children, and adolescents-Different roles of the methods in different age groups. Plos One. 2019;17;14:e0210805.
14Kieling CO, Hallal C, Spessato CO, Ribeiro LM, Breyer H, Goldani HA, et al. Changing pattern of indications of endoscopic retrograde cholangiopancreatography in children and adolescents: a twelve-year experience. World J Pediatr 2015;11:154-9.
15Usatin D, Fernandes M, Allen IE, Perito ER, Ostroff J, Heyman MB. Complications of Endoscopic Retrograde Cholangiopancreatography in Pediatric Patients: A Systematic Literature Review and Meta-Analysis. J Pediatr 2016;179:160-5.
16Paris C1, Bejjani J, Beaunoyer M, Ouimet A. Endoscopic retrograde cholangiopancreatography is useful and safe in children. J Pediatr Surg 2010;45:938-42.
17Todani T, Watanabe Y, Narusue M, Tabuchi K, Okajima K. Congenital bile duct cysts: Classification, operative procedures, and review of thirty-seven cases including cancer arising from choledochal cyst. American Journal of Surgery 1977;134:263-9.
18Kamisawa T, Ando H, Hamada Y, Fujii H, Koshinaga T, Urushihara N, et al. Diagnostic criteria for pancreaticobiliary maljunction 2013. J. Hepatobiliary Pancreat Sci 2014;21:159-61.
19Dowdy GS Jr, Waldron GW, Brown WG. Surgical anatomy of the pancreatobiliary ductal system. Observations. ArchSurg 1962;84:229-46.
20Oguz D, Şahin B. Safra yollarının kistik hastalıkları. ERCP Editörler: Erkan Parlak, Burhan Şahin. 1. Baskı, 2012; Bölüm (36):294-313.
Article is only available in PDF format. Show PDF
2024 ©️ Galenos Publishing House