Endoscopic retrograde cholangiopancreatography is useful and safe in children

Paris, Catherine; Bejjani, Jimmy; Beaunoyer, Mona; Ouimet, Alain

doi:10.1016/j.jpedsurg.2010.02.009

Cited by 53 publications

(49 citation statements)

References 27 publications

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“…In our study, the most common indications for ERCP were similar to accepted adult indications and those reported in other similar case series [3,17].…”

Section: Discussionsupporting

confidence: 88%

“…Of 68 patients with recurrent pancreatitis, 27 received a diagnosis of idiopathic recurrent acute pancreatitis because organic etiologies were not found. However, despite a lack of consensus on the role of ERCP in the evaluation of idiopathic recurrent abdominal pain or pancreatitis [3,8,9], etiologies were identified in 41 of 68 patients (60%) in our study who underwent ERCP for recurrent pancreatitis. Sphincter of Oddi dysfunction was diagnosed for 11 of these patients, established by sphincter of Oddi manometry during ERCP [10], underscoring the importance of the role of ERCP in children with recurrent biliary or pancreatic abdominal pain.…”

Section: Discussionmentioning

confidence: 76%

“…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%

“…Notable issues include the relative rarity of pancreaticobiliary diseases requiring surgery among children, the relatively recent advent of the pediatric duodenoscope, and the lack of safety information and accepted indications for ERCP in children [2]. Importantly, rates for complications after ERCP in children have not been well established, in part because most published case series have been limited by small sample sizes [3]. To address this issue and the paucity of evidence-based guidelines for the use of ERCP, we examined the utility and safety of ERCP in the diagnosis and therapy of common pediatric surgical conditions at a large, university-based children's hospital.…”

mentioning

confidence: 99%

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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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“…In our study, the most common indications for ERCP were similar to accepted adult indications and those reported in other similar case series [3,17].…”

Section: Discussionsupporting

confidence: 88%

Section: Discussionmentioning

confidence: 76%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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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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“…However, as in adults, cystic type I is the form most frequently observed in both infants and older children [15]. Endoscopic retrograde cholangiopancreatography under general anesthesia [16] and magnetic resonance cholangiopancreatography (MRCP) [22] are recommended diagnostic approaches for choledochal cysts in children although prenatal ultrasonography results in earlier definitive surgery with lesser complications [8]. Laparoscopic Roux-en-Y hepaticojejunostomy is reported to be safe for both infants and children [8,12,14,15].…”

Section: Introductionmentioning

confidence: 99%

Choledochal cysts in infants and children: experiences over a 20-year period at a single institution

et al. 2011

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This analysis was undertaken to compare the clinicopathological features of infants with choledochal cysts to those of older children with these entities and to evaluate the surgical outcomes for both subject groups. The medical records of all children admitted to the Cathay General Hospital with choledochal cysts over a 20-year period were retrospectively reviewed. Twenty-five subjects were included and divided into the infant (<1 year at presentation; 8 subjects) and classical pediatric (1-18 years at presentation; 17 subjects) groups. Anatomical subtypes were: IA (16), IC (6), and IVA (3). The median biliary amylase value was markedly elevated for the pediatric group but not for the infant group. Most (82.4%) patients in the pediatric group, but none in the infant group, presented with abdominal pain. Jaundice and clay-colored stool were present in all patients in the infant group but only 35% of those in the pediatric group. All patients underwent choledochocystectomy and Roux-en-Y hepaticojejunostomy with good outcomes. Neonates/infants with choledochal cysts present differently from older children with these entities. Amylase measurements may serve to distinguish biliary atresia with cystic dilatation from choledochal cyst in neonates/infants. Prognosis following radical cyst excision and reconstruction with Roux-en-Y hepaticojejunostomy is excellent.

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Availability and utilization of endoscopic retrograde cholangiopancreatography at children's hospitals

Pathak,

Attard,

Hall

et al. 2024

J. pediatr. gastroenterol. nutr.

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ObjectivesNo study has explored whether availability of endoscopic retrograde cholangiopancreatography (ERCP) is adequate and equitable across US children's hospitals. We hypothesized that ERCP availability and utilization differs by geography and patient factors.MethodsHealthcare encounter data from 2009 to 2019 on children with pancreatic and biliary diseases from the Pediatric Health Information System were analyzed. ERCP availability was defined as treatment at a hospital that performed pediatric ERCP during the year of service.ResultsFrom 2009 to 2019, 37,946 children (88,420 encounters) had a potential pancreatic or biliary indication for ERCP; 7066 ERCPs were performed. The commonest pancreatic diagnoses leading to ERCP were chronic (47.2%) and acute pancreatitis (43.2%); biliary diagnoses were calculus (68.3%) and obstruction (14.8%). No ERCP was available for 25.0% of pancreatic encounters and 8.1% of biliary encounters. In multivariable analysis, children with public insurance, rural residence, or of Black race were less likely to have pancreatic ERCP availability; those with rural residence or Asian race were less likely to have biliary ERCP availability. Black children or those with public insurance were less likely to undergo pancreatic ERCP where available. Among encounters for calculus or obstruction, those of Black race or admitted to hospitals in the West were less likely to undergo ERCP when available.ConclusionsOne‐in‐four children with pancreatic disorders and one‐in‐12 with biliary disorders may have limited access to ERCP. We identified racial and geographic disparities in availability and utilization of ERCP. Further studies are needed to understand these differences to ensure equitable care.

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Endoscopic retrograde cholangiopancreatography is useful and safe in children

Cited by 53 publications

References 27 publications

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

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

Choledochal cysts in infants and children: experiences over a 20-year period at a single institution

Availability and utilization of endoscopic retrograde cholangiopancreatography at children's hospitals

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