Safety & efficacy of ERCP in childrens & aldolescents using standard scopes

Abstract

Background: Experience with endoscopic retrograde cholangiopancreatography in the pediatric population was limited. The experience was limited due to multiple factors, including the relatively low incidence of diseases requiring ERCP in this age group and the impression that the procedure is technically difficult in children.

OBJECTIVES: The aims and objectives of this study were indications, findings, therapies, safety, technical success, the effect on management and complications of ERCP in children and adolescents (1-18yrs of age). All the children referred/admitted to gastroenterology for ERCP due to various biliopancreatic problems were included in this study.

STUDY DESIGN: Retrospective observational hospital-based study from Oct 2013 to Oct 2019.

RESULTS: A total of 156 patients were included in this study with a mean age of 13.7years (Range 1.5-18 years). The most common indications for ERCP were biliary obstruction in 56%, biliary colics 31%, recurrent acute pancreatitis 18%, bile leak 8%, AP with cholangitis 6% respectively. The overall cannulation rate was 97% with 95% cannulation in the first procedure & with 91% with standard cannulation. The most common complication was PEP 5%, followed by post ERCP sepsis in 3% & Post papillotomy bleed in 2 % & Post ERCP perforation in 1% respectively with an overall complication rate of 11% & all complications were managed conservatively with no postprocedural related mortality.

CONCLUSION: When performed by well-trained adult gastroenterologists, the use of endoscopic retrograde cholangiopancreatography with standard duodenoscopes is safe in Pediatric & Adolescent population.