Endoscopic retrograde cholangiopancreatography in children: A surgeon's perspective

Prasil, Pascale; Laberge, Jean-Martin; Barkun, Alan N.; Flageole, Hélène

doi:10.1053/jpsu.2001.22948

Cited by 49 publications

(31 citation statements)

References 9 publications

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“…The most frequent complications were pancreatitis and post-sphincterotomy bleeding. Whereas these complications occurred more frequently in patients undergoing "advanced" therapeutic procedures, such as sphincterotomy for sphincter of Oddi dysfunction or treatment of pancreatic ductal abnormalities, pancreatitis has been reported in 5% to 33% of children undergoing diagnostic ERCP [2,3]. In our study, only 15% of children evaluated initially by MRCP and 20% evaluated initially by ERCP required a therapeutic procedure.…”

Section: Discussioncontrasting

confidence: 48%

“…Although not specifically reported in the MRCP literature, movement of ferromagnetic implants (vascular clips, pacemakers, ocular implants), external metallic objects (oxygen tanks, scissors, scalpels cleaning equipment), and thermal injury from external wires (electrocardiogram electrodes) have resulted in rare reports of injury and death in children receiving magnetic resonance studies [27,28]. The reported rate of complications for ERCP performed in children is 2% to 8% [1][2][3]6]. The most frequent complications were pancreatitis and post-sphincterotomy bleeding.…”

Section: Discussionmentioning

confidence: 99%

“…Unfortunately ERCP is often available only in specialty settings. In addition, it is invasive, requires significant radiation exposure, carries infrequent but significant risk, and is expensive [1][2][3][4][5][6]. A noninvasive, lower-risk, and widely available technique is needed.…”

Section: Introductionmentioning

confidence: 99%

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The use of magnetic resonance cholangiopancreatography in children

Tipnis¹,

Werlin

2007

Curr Gastroenterol Rep

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Magnetic resonance cholangiopancreatography (MRCP) is a noninvasive method to evaluate a wide variety of pancreatobiliary disorders. These disorders include choledochal cyst, cholelithiasis, choledocholithiasis, biliary atresia, Caroli's disease, primary sclerosing cholangitis, disorders of the pancreatobiliary junction, pancreas divisum, and pancreatic duct abnormalities related to chronic pancreatitis. The use of MRCP in children is increasing as experience with MRCP grows, and its technological accuracy rivals that of endoscopic evaluation. We review the current state of MRCP use in children.

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Section: Discussioncontrasting

confidence: 48%

Section: Discussionmentioning

confidence: 99%

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The use of magnetic resonance cholangiopancreatography in children

Tipnis¹,

Werlin

2007

Curr Gastroenterol Rep

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“…The reported incidence of ERCP-related morbidity in children ranges from 0% to 28.5%, with pancreatitis being the most common complication [3,13,17,[24][25][26][27]. Strikingly, in our study, both the overall complication rate of 4.76% and the post-ERCP pancreatitis rate of 3% were lower than or similar to the respective adult rates of 6% to 10% and 3% reported in a systematic review [28] and lower than the rates of 8% and 4% reported by a prospective multicenter study [28,29].…”

Section: Discussionmentioning

confidence: 99%

An appraisal of endoscopic retrograde cholangiopancreatography (ERCP) for pancreaticobiliary disease in children: our institutional experience in 231 cases

et al. 2011

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“…For pediatric patients and those with low respiratory reserve, general anesthesia is required. Morbidity from ERCP ranges from 2%-8% in children and 1%-2% in adults, which rises to 10% when combined with sphincterotomy, and mortality estimates is estimated between 0.05%-0.90% [42,[49][50][51][52][53] . Cholangitis, duodenal perforation, hemorrhage, contrast allergy, biliary sepsis, and pancreatitis are all recognized complications.…”

Section: Mrcp Vs Ercpmentioning

confidence: 99%

Role of magnetic resonance cholangiopancreatography in diagnosing choledochal cysts: Case series and review

Sacher

Davis²,

Sleeman³

et al. 2013

WJR

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AIM:To determine the merits of magnetic resonance cholangiopancreatography (MRCP) as the primary diagnostic test for choledochal cysts (CC's). METHODS:Between 2009 and 2012, patients who underwent MRCP for perioperative diagnosis were identified. Demographic information, clinical characteristics, and radiographic findings were recorded. MRCP results were compared with intraoperative findings. A PubMed search identified studies published between 1996-2012, employing MRCP as the primary preoperative imaging and comparing results with either endoscopic retrograde cholangiopancreatography (ERCP) or operative findings. Detection rates for CC's and abnormal pancreaticobiliary junction (APBJ) were calculated. In addition detection rates for clinically related biliary pathology like choledocholithiasis and cholangiocarcinomas in patients diagnosed with CC's were also evaluated. RESULTS:Eight patients were identified with CC's. Six patients out of them had type Ⅳ CC's, 1 had type I and 1 had a new variant of choledochal cyst with confluent dilatation of the common bile duct (CBD) and cystic duct. Seven patients had an APBJ and 3 of those had a long common-channel. Gallstones were found in 2 patients, 1 had a CBD stone, and 1 pancreatic-duct stone was also detected. In all cases, MRCP successfully identified the type of CC's, as well as APBJ with ductal stones. From analyzing the literature, we found that MRCP has 96%-100% detection rate for CC's. Additionally, we found that the range for sensitivity, specificity, and diagnostic accuracy was 53%-100%, 90%-100% and 56%-100% in diagnosing APBJ. MRCP's detection rate was 100% for choledocholithiasis and 87% for cholangiocarcinomas with concurrent CC's. CONCLUSION:After initial ultrasound and computed tomography scan, MRCP should be the next diagnostic test in both adult and pediatric patients. ERCP should be reserved for patients where therapeutic intervention is needed.© 2013 Baishideng. All rights reserved.Key words: Magnetic resonance cholangiopancreatography; Choledochal cyst; Abnormal pancreaticobiliary junction; Diagnostic test; Choledocholithiasis; Cholangiocarcinomas Core tip: Magnetic resonance cholangiopancreatography (MRCP) is used as primary diagnostic approach in various biliary pathologies. This is the first literature review of published studies discussing MRCP as a diagnostic modality for choledochal cysts. This review further outlines how recent imaging techniques have improved diagnostic accuracy of MRCP in diagnosing choledochal cysts and their associated anatomic variants. Advantages, disadvantages and contraindication for MRCP with respect to endoscopic retrograde cholangiopancreatography are also discussed.

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Endoscopic retrograde cholangiopancreatography in children: A surgeon's perspective

Cited by 49 publications

References 9 publications

The use of magnetic resonance cholangiopancreatography in children

The use of magnetic resonance cholangiopancreatography in children

An appraisal of endoscopic retrograde cholangiopancreatography (ERCP) for pancreaticobiliary disease in children: our institutional experience in 231 cases

Role of magnetic resonance cholangiopancreatography in diagnosing choledochal cysts: Case series and review

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