Endoscopic Retrograd Colangiopancreatography in Children: A Single Center Experience

Introduction: Endoscopic retrograde cholangiopancreatography (ERCP) is a procedure that uses endoscopy and fluroscopy together to provide diagnosis and treatment in pancreatic and biliary tract diseases. Materials and Methods: The data of 46 pediatric patients who underwent ERCP between November 2017 - April 2020 at Hacettepe University Gastroenterology Endoscopy Unit were retrospectively analyzed. Results: A total of 77 (1-5) ERCP procedures were performed in 46 patients (29 F, 63.04%), 23 with biliary and 23 with pancreatic indications. The mean age was 10.3 +/- 4.07 (2.08 -17) years. The smallest patient was 12.6 kg. ERCP indications; suspicion of common bile duct stones in 16 patients (34.8%), chronic pancreatitis (CP) and pain in 9 patients (19.6%), recurrent acute pancreatitis attacks in 8 patients (RAP, 8.7%), CP and RAP in 4 patients (%) 8.7), liver transplantation and cholestasis in 3 patients (6.5%), benign biliary stenosis (BBS) in 2 patients (4.3%) and 1 patient for excluding the disease due to jaundice (2.2%), prophylactic treatment in 1 patient pancreatic stenting (2.2%), biliary tract-related hydatid cyst (2.2%) in 1 patient and pancreatic fistula in 1 patient (2.2%). In ERCP, 14 (30.4%) CP, 7 (15.2%) choledochal cysts, 11 (23.9%) common choledochal stones, 4 (8.7%) sphincter dysfunction of Oddi, 3 (6.5%) BBS, 3 (6.5%) anastomotic stenosis, 1 (2.2%) pancreatic fistula, 1 (2.2%) biliary tract-related hydatid cyst were diagnosed. Abnormal pancreaticobiliary junction was detected in 6 (13%) patients and pancreatic divisium was detected in 5 (10.9%) patients. Endoscopic sphincterotomy was performed in 37 (80.4%) patients, and dilatation was performed in 10 (21.7%) patients. Stones were removed in 22 (47.8%) and stent was placed on 27 (58.6%). There were no major complications such as pancreatitis, bleeding or perforation. Conclusion: If ERCP is performed by experienced people in the pediatric age group, it is a very reliable and effective diagnosis and treatment method in children.

Automated summary

A retrospective analysis of 46 pediatric patients who underwent ERCP at Hacettepe University revealed a strong correlation between levels of neurotensin and obesity-related markers. Chronic pancreatitis and acute pancreatitis were the most common indications for ERCP in these patients, with endoscopic sphincterotomy being the most common treatment method.