Our endoscopic retrograde cholangiopancreatography (ERCP) experience in pediatric patients in a training and research hospital

Background

Endoscopic retrograde cholangiopancreatography (ERCP) was first applied in 1976 in children for diagnosing and treating pancreaticobiliary diseases based on experience with adult patients. Its application was limited initially but has become widespread in recent years with technical developments. This study evaluated the efficacy, indications, and complications of the ERCP's diagnostic and therapeutic use in pediatric patients.

Case Series

We evaluated retrospectively the files of 16 pediatric patients aged 5-18 years who underwent ERCP between January 2015 and June 2022 in the Endoscopy Unit of Prof. Dr. Cemil Taşçıoğlu City Hospital. We recorded and analyzed the demographic data, admission complaints, pre-procedure diagnostic tests, ERCP findings, and early and late post-procedure complications. Five of the 16 patients (31 %) who underwent ERCP were male, 11 (69 %) were female, and their mean age was 12.7 ± 5.44. We utilized as a diagnostic tool the Fujifilm ED-580XT duodenoscope with a 13.4 mm outer diameter and a 4.4 mm diameter channel connected to a Fujinon Eluxeo 6000 light source, not specifically designed for children but in use for adult patients. While biochemistry and ultrasonography were conducted for all patients before the procedure, only ten patients (62 %) underwent magnetic resonance cholangiopancreatography. Indications for performing ERCP included suspected biliary pathology (8 patients, 50 %), pancreatitis attack (6 patients, 38 %), bile leakage after cholecystectomy (one patient, 6 %), and mass lesion in the ampulla (one patient, 6 %). Seven patients (44 %) underwent cholecystectomy for cholelithiasis 4-6 weeks after the ERCP (one cholecystectomy was performed in another center). In one of the patients, ERCP was performed for diagnostic-only purposes, while in fifteen patients was performed for diagnostic and therapeutic purposes (partial sphincterotomy and stent placement). While none of the patients had complications in the early post-procedure period, one experienced an acute pancreatitis episode in the late post-procedure period.

Conclusion

With the increase in endoscopists' experience and technological developments in different age groups, ERCP is a safe and effective method for diagnosing and treating pancreaticobiliary diseases in children. HIPPOKRATIA 2022, 26 (4):152-156.