Is Endoscopic Retrograde Cholangiopancreatography Valuable and Safe in Children of All Ages?

Abstract

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.

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

“…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]. No complications were seen in infants younger than 1 year, supporting a previous series demonstrating the safety of ERCP for infants [24].…”

“…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].…”

Laparoscopic choledochal cyst excision, hepaticojejunostomy, and extracorporeal Roux-en-Y anastomosis: a technical skill and intermediate-term report in 62 cases

“…Endoscopic retrograde cholangiopancreatography (ERCP) is an ideal method for obtaining an accurate anatomic structure of the biliary tree and pancreatic ducts, but it is invasive and may involve the risk of acute cholangitis, pancreatitis, or bile leakage. Therefore, its use has been restricted in the diagnosis of children because of the instruments and the technology [8].…”

Percutaneous management of bile duct stones in children: results of 12 cases

“…ERCP has 95%-100% success rate and 3.2%-7.7% complication rate (4,5,(14)(15)(16)(17). Effect of sphincterotomy on the papilla such as biliopancreatic reflux, cholangitis, and the risk of papillary stenosis is unclear in children over the long-term.…”