Is endoscopic retrograde cholangiopancreatography valuable and safe in children of all ages?

Abstract

OBJECTIVE:

To evaluate indications, findings, therapies, safety, and technical success of endoscopic retrograde cholangiopancreatography (ERCP) in children of the Emma Children's Hospital Academic Medical Centre in Amsterdam, the Netherlands.

DESIGN:

Descriptive. Retrospective analysis by medical records.

PATIENTS AND METHODS:

Information was obtained by chart review of patients between 0 and 18 years who underwent ERCP from 1995 to 2005 in our center. The following data were analyzed: indications, findings, therapies, safety, and technical success. Success was defined as obtaining accurate diagnostic information or succeeding in endoscopic therapy.

RESULTS:

Sixty-one children (age 3 days to 16.9 years, mean age 7.0 years) underwent a total of 99 ERCPs. Of those patients, 51% (31/61) were younger than 1 year, 84% had biliary indications, and 16% had pancreatic indications for the performance of ERCP. The complication rate was 4% (4/99) and included substantial pancreatitis and mild irritated pancreas. No complications occurred in children younger than 1 year.

CONCLUSIONS:

ERCP is a safe and valuable procedure for children of all ages with suspicion of pancreaticobiliary diseases. Indications for ERCP are different for children and adults. A laparotomy could be prevented in 12% of children with suspicion of biliary atresia. Further research is required to determine the role of MRCP versus ERCP.

• Authors: I L Vegting, M M Tabbers, J A J M Taminiau, D C Aronson, M A Benninga, E A J Rauws
• Journal: Journal of pediatric gastroenterology and nutrition (J Pediatr Gastroenterol Nutr) Vol. 48 Issue 1 Pg. 66-71 (Jan 2009) ISSN: 1536-4801 [Electronic] United States
• PMID: 19172126 (Publication Type: Journal Article)

Topics

• Adolescent
• Biliary Atresia (diagnosis, surgery)
• Biliary Tract Diseases (diagnosis, surgery)
• Child
• Child, Preschool
• Cholangiopancreatography, Endoscopic Retrograde (adverse effects)
• Cholangitis, Sclerosing (diagnosis, surgery)
• Choledochal Cyst (diagnosis, surgery)
• Choledocholithiasis (diagnosis, surgery)
• Female
• Humans
• Infant
• Infant, Newborn
• Jaundice, Obstructive (diagnosis, surgery)
• Liver (injuries)
• Male
• Pancreas (injuries)
• Pancreatic Diseases (diagnosis, surgery)
• Pancreatitis (diagnosis, surgery)
• Retrospective Studies
• Safety
• Treatment Outcome