TY - JOUR
T1 - Endoscopic retrograde cholangiopancreatography in the pediatric population is safe and efficacious
AU - Enestvedt, Brintha K.
AU - Tofani, Christina
AU - Lee, Dale Y.
AU - Abraham, Maíre
AU - Shah, Pari
AU - Chandrasekhara, Vinay
AU - Ginsberg, Gregory G.
AU - Long, William
AU - Ahmad, Nuzhat
AU - Jaffe, David L.
AU - Mamula, Petar
AU - Kochman, Michael L.
PY - 2013/11
Y1 - 2013/11
N2 - BACKGROUND:: Endoscopic retrograde cholangiopancreatography (ERCP) is increasingly being used in the evaluation and management of biliary and pancreatic disorders in children. The aim of this study was to review the pediatric ERCP experience of a large academic referral center affiliated with a tertiary care children's hospital. METHODS:: This is a retrospective review of medical records, endoscopic and operative reports, and radiography of those patients ages 0 to 21 years who underwent ERCP for any indication between 1993 and 2011 at a tertiary referral center affiliated with a large urban pediatric hospital. ERCP technical success was defined as cannulation of the desired duct. Serious adverse events included bleeding, perforation, pancreatitis, or death. RESULTS:: Four hundred twenty-nine ERCPs were performed on 296 patients. The mean age was 14.9±4.8 years (3 months-21 years); 51.1% were boys. Patients with a history of previous liver transplant comprised 13.1% (56) of all ERCPs. Abnormal liver chemistries or suspected choledocholithiasis accounted for half of the indications. A therapeutic intervention was performed in 64.1%. Technical success was achieved in 95.2% of ERCPs. Serious adverse events occurred in 7.7%. CONCLUSIONS:: Pediatric ERCP is highly efficacious in the pediatric population, with the rates of technical success and use of therapeutic interventions mirroring those in adults. There is a low overall rate of serious adverse events. The overall efficacy and safety support the performance of pediatric ERCP by experienced endoscopists at high-volume centers.
AB - BACKGROUND:: Endoscopic retrograde cholangiopancreatography (ERCP) is increasingly being used in the evaluation and management of biliary and pancreatic disorders in children. The aim of this study was to review the pediatric ERCP experience of a large academic referral center affiliated with a tertiary care children's hospital. METHODS:: This is a retrospective review of medical records, endoscopic and operative reports, and radiography of those patients ages 0 to 21 years who underwent ERCP for any indication between 1993 and 2011 at a tertiary referral center affiliated with a large urban pediatric hospital. ERCP technical success was defined as cannulation of the desired duct. Serious adverse events included bleeding, perforation, pancreatitis, or death. RESULTS:: Four hundred twenty-nine ERCPs were performed on 296 patients. The mean age was 14.9±4.8 years (3 months-21 years); 51.1% were boys. Patients with a history of previous liver transplant comprised 13.1% (56) of all ERCPs. Abnormal liver chemistries or suspected choledocholithiasis accounted for half of the indications. A therapeutic intervention was performed in 64.1%. Technical success was achieved in 95.2% of ERCPs. Serious adverse events occurred in 7.7%. CONCLUSIONS:: Pediatric ERCP is highly efficacious in the pediatric population, with the rates of technical success and use of therapeutic interventions mirroring those in adults. There is a low overall rate of serious adverse events. The overall efficacy and safety support the performance of pediatric ERCP by experienced endoscopists at high-volume centers.
KW - children
KW - pancreaticobiliary disease
KW - pediatric ERCP
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U2 - 10.1097/MPG.0b013e31829e0bb6
DO - 10.1097/MPG.0b013e31829e0bb6
M3 - Article
C2 - 23760230
AN - SCOPUS:84888127622
SN - 0277-2116
VL - 57
SP - 649
EP - 654
JO - Journal of pediatric gastroenterology and nutrition
JF - Journal of pediatric gastroenterology and nutrition
IS - 5
ER -