Korean J Gastrointest Endosc.  2010 Sep;41(3):140-146.

A Single Institution's Experience of Ten Pediatric Patients with Endoscopic Retrograde Cholangiopancreatography

Affiliations
  • 1Division of Gastroenterology, Department of Internal Medicine, Soonchunhyang University Cheonan Hospital, Soonchunhyang University College of Medicine, Cheonan, Korea. pparksh@sch.ac.kr
  • 2Division of Gastroenterology, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

Abstract

BACKGROUND/AIMS
ERCP is being used increasingly as a diagnostic and therapeutic tool for children with pancreaticobiliary disorders. Differences between thirteen pediatric ERCPs and adult ERCPs were reviewed with respect to their indications, method of anesthesia, choice of endoscope and complications.
METHODS
The medical records of 13 ERCPs for 10 children (age: 23 months to 14 years) done between 2005 and 2008 were reviewed retrospectively.
RESULTS
ERCP was indicated for gallstone pancreatitis (6), choledocholithiasis (3), and unexplained pain (1). The method of anesthesia was intravenous sedation with a single agent or a combination of midazolam, propofol or ketamine. The quality of sedation was satisfactory in 10 cases and unsatisfactory in three cases. These 3 cases were less than 8 years old and sedated with a combination of midazolam and propofol. Selective biliary cannulation was successful in 92.3% (12/13) of attempts. Therapeutic ERCP included sphincterotomy (4), endoscopic papillary balloon dilatation (3), and both (5). Complications occurred in 7.7% of attempts (1/13; 1 duodenal perforation) which was successfully managed by surgery.
CONCLUSIONS
Pediatric ERCP is a feasible and useful technique. Special caution is needed, however, because of differences with adult ERCP in terms of the effectiveness of intravenous sedation, complications, and size of the gastrointestinal tract.

Keyword

ERCP; Children

MeSH Terms

Adult
Anesthesia
Catheterization
Child
Cholangiopancreatography, Endoscopic Retrograde
Choledocholithiasis
Dilatation
Endoscopes
Gallstones
Gastrointestinal Tract
Humans
Ketamine
Medical Records
Midazolam
Pancreatitis
Propofol
Retrospective Studies
Ketamine
Midazolam
Propofol
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