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

Park, Jin-Woo (Division of Gastroenterology, Department of Internal Medicine, Soonchunhyang University Cheonan Hospital,Soonchunhyang University College of Medicine)
Park, Sang-Heum (Division of Gastroenterology, Department of Internal Medicine, Soonchunhyang University Cheonan Hospital,Soonchunhyang University College of Medicine)
Lee, Tae-Hoon (Division of Gastroenterology, Department of Internal Medicine, Soonchunhyang University Cheonan Hospital,Soonchunhyang University College of Medicine)
Shim, Yun-Suk (Division of Gastroenterology, Department of Internal Medicine, Soonchunhyang University Cheonan Hospital,Soonchunhyang University College of Medicine)
Hwang, Soon-Oh (Division of Gastroenterology, Department of Internal Medicine, Soonchunhyang University Cheonan Hospital,Soonchunhyang University College of Medicine)
Kim, Sang-Pil (Division of Gastroenterology, Department of Internal Medicine, Soonchunhyang University Cheonan Hospital,Soonchunhyang University College of Medicine)
Lee, Jun-Young (Division of Gastroenterology, Department of Internal Medicine, Soonchunhyang University Cheonan Hospital,Soonchunhyang University College of Medicine)
Lee, Seo-Whan (Division of Gastroenterology, Department of Internal Medicine, Soonchunhyang University Cheonan Hospital,Soonchunhyang University College of Medicine)
Lee, Chang-Kwun (Division of Gastroenterology, Department of Internal Medicine, Soonchunhyang University Cheonan Hospital,Soonchunhyang University College of Medicine)
Park, Do-Hyun (Asan Medical Center, University of Ulsan College of Medicine)
Lee, Suck-Ho (Division of Gastroenterology, Department of Internal Medicine, Soonchunhyang University Cheonan Hospital,Soonchunhyang University College of Medicine)
Chung, Il-Kwun (Division of Gastroenterology, Department of Internal Medicine, Soonchunhyang University Cheonan Hospital,Soonchunhyang University College of Medicine)
Kim, Hong-Soo (Division of Gastroenterology, Department of Internal Medicine, Soonchunhyang University Cheonan Hospital,Soonchunhyang University College of Medicine)
Kim, Sun-Joo (Division of Gastroenterology, Department of Internal Medicine, Soonchunhyang University Cheonan Hospital,Soonchunhyang University College of Medicine)
Publication Information
Clinical Endoscopy / v.41, no.3, 2010 , pp. 140-146 More about this Journal
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.
Keywords
ERCP; Children;
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1 Graham KS, Ingram JD, Steinberg SE, Narkewicz MR. ERCP in the management of pediatric pancreatitis. Gastrointest Endosc 1998;47:492-495.   DOI   ScienceOn
2 Guelrud M, Mendoza S, Jaen D, Plaz J, Machuca J, Torres P. ERCP and endoscopic sphincterotomy in infants and children with jaundice due to common bile duct stones. Gastrointest Endosc 1992;38:450-453.   DOI   ScienceOn
3 Watanabe H, Yoneda M, Tominaga K, et al. Comparison between endoscopic papillary balloon dilatation and endoscopic sphincterotomy for the treatment of common bile duct stones. J Gastroenterol 2007;42:56-62.   DOI   ScienceOn
4 Baron TH, Harewood GC. Endoscopic balloon dilation of the biliary sphincter compared to endoscopic biliary sphincterotomy for removal of common bile duct stones during ERCP: a metaanalysis of randomized, controlled trials. Am J Gastroenterol 2004;99:1455-1460.   DOI   ScienceOn
5 Krauss B, Green SM. Sedation and analgesia for procedures in children. N Engl J Med 2000;30:938-945.
6 Brown KO, Goldschmiedt M. Endoscopic therapy of biliary and pancreatic disorders in children. Endoscopy 1994;26:719-723.   DOI   ScienceOn
7 Eisen GM, Chutkan R, Goldstein JL, et al. Modifications in endoscopic practice for pediatric patients. Gastrointest Endosc 2000;52:838-842.   DOI   ScienceOn
8 Guelrud M, Jaen D, Mendoza S, Plaz J, Torres P. ERCP in the diagnosis of extrahepatic biliary atresia. Gastrointest Endosc 1991;37:522-526.   DOI   ScienceOn
9 Cotton PB, Laage NJ. Endoscopic retrograde cholangiopancreatography in children. Arch Dis Child 1982;57:131-136.   DOI   ScienceOn
10 Allendorph M, Werlin SL, Geenen JE, et al. Endoscopic retrograde cholangiopancreatography in children. J Pediatr 1987;110:206-211.   DOI
11 Brown CW, Werlin SL, Geenen JE, Schmalz M. The diagnostic and therapeutic role of endoscopic retrograde cholangiopancreatography in children. J Pediatr Gastroenterol Nutr 1993;17:19-23.   DOI   ScienceOn
12 Dohke M, Watanabe Y, Okumura A, et al. Anomalies and anatomic variants of the biliary tree revealed by MR cholangiopancreatography. AJR Am J Roentgenol 1999;173:1251-1254.   DOI   ScienceOn
13 Werlin SL. Endoscopic retrograde cholangiopancreatography in children. Gastrointest Endosc Clin N Am 1994;4:161-178.
14 Hsu RK, Draganov P, Leung JW, et al. Therapeutic ERCP in the management of pancreatitis in children. Gastrointest Endosc 2000;51:396-400.   DOI   ScienceOn
15 Goulson DT, Fragneto RY. Anesthesia for gastrointestinal endoscopic procedures. Anesthesiol Clin 2009;27:71-85.   DOI   ScienceOn
16 Hammer GB, Litalien C, Wellis V, Drover DR. Determination of the median effective concentration (EC50) of propofol during oesophagogastroduodenoscopy in children. Paediatr Anaesth 2001;11:549-553.   DOI   ScienceOn
17 Taourel P, Bret PM, Reinhold C, Barkun AN, Atri M. Anatomic variants of the biliary tree: diagnosis with MR cholangiopancreatography. Radiology 1996;199:521-527.   DOI
18 Jung SH, Kim KM, Seo DW, et al. Endoscopic retrograde cholangiopancreatography in thirty-four children. Korean J Gastrointest Endosc 2003;26:418-425.
19 Guelrud M, Mujica C, Jaen D, Plaz J, Arias J. The role of ERCP in the diagnosis and treatment of idiopathic recurrent pancreatitis in children and adolescents. Gastrointest Endosc 1994;40:428-436.   DOI   ScienceOn
20 Ashida K, Nagita A, Sakaguchi M, Amemoto K, Tada H. Endoscopic retrograde cholangiopancreatography in paediatric patients with biliary disorders. J Gastroenterol Hepatol 1998;13:598-603.   DOI   ScienceOn
21 Powers KS, Nazarian EB, Tapyrik SA, et al. Bispectral index as a guide for titration of propofol during procedural sedation among children. Pediatrics 2005;115:1666-1674.   DOI   ScienceOn
22 Pfau PR, Chelimsky GG, Kinnard MF, et al. Endoscopic retrograde cholangiopancreatography in children and adolescents. J Pediatr Gastroenterol Nutr 2002;35:619-623.   DOI   ScienceOn
23 Neuhauser C, Wagner B, Heckmann M, Weigand MA, Zimmer KP. Analgesia and sedation for painful interventions in children and adolescents. Dtsch Arztebl Int 2010;107:241-247.
24 Arcement CM, Meza MP, Arumanla S, Towbin RB. MRCP in the evaluation of pancreaticobiliary disease in children. Pediatr Radiol 2001;31:92-97.   DOI   ScienceOn
25 Prasil P, Laberge JM, Barkun A, Flageole H. Endoscopic retrograde cholangiopancreato-graphy in children: a surgeon's perspective. J Pediatr Surg 2001;36:733-735.   DOI   ScienceOn
26 Guelrud M, Jaen D, Torres P, et al. Endoscopic cholangiopancreatography in the infant: evaluation of a new prototype pediatric duodenoscope. Gastrointest Endosc 1987;33:4-8.   DOI   ScienceOn
27 Choi SM, Kim KJ, Kim BN, et al. A case of endoscopic retrograde cholangiopancreatography and endoscopic sphincterotomy in infant having choledochal cyst and CBD stones. Korean J Gastrointest Endosc 1996;16:261-267.
28 Cotton PB, Lehman G, Vennes J, et al. Endoscopic sphincterotomy complications and their management: an attempt at consensus. Gastrointest Endosc 1991;37:383-393.   DOI   ScienceOn
29 Buckley A, Connon JJ. The role of ERCP in children and adolescents. Gastrointest Endosc 1990;36:369-372.   DOI   ScienceOn
30 Fox VL, Werlin SL, Heyman MB. Endoscopic retrograde cholangiopancreatography in children. Subcommittee on Endoscopy and Procedures of the Patient Care Committee of the North American Society for Pediatric Gastroenterology and Nutrition. J Pediatr Gastroenterol Nutr 2000;30:335-342.   DOI   ScienceOn
31 Varadarajulu S, Wilcox CM, Hawes RH, Cotton PB. Technical outcomes and complications of ERCP in children. Gastrointest Endosc 2004;60:367-371.   DOI   ScienceOn
32 Putnam PE, Kocoshis SA, Orenstein SR, Schade RR. Pediatric endoscopic retrograde cholangiopancreatography. Am J Gastroenterol 1991;86:824-830.
33 Teng R, Yokohata K, Utsunomiya N, Takahata S, Nabae T, Tanaka M. Endoscopic retrograde cholangiopancreatography in infants and children. J Gastroenterol 2000;35:39-42.   DOI   ScienceOn
34 Choi BH, Lim YJ, Yoon CH, Kim EA, Park YS, Kim KM. Acute pancreatitis associated with biliary disease in children. J Gastroenterol Hepatol 2003;18:915-921.   DOI   ScienceOn