Efficacy of ERCP in infancy and childhood

TY - JOUR

T1 - Efficacy of ERCP in infancy and childhood

AU - Reinshagen, K

AU - Müldner, A

AU - Manegold, B

AU - Kähler, G

PY - 2007/9/1

Y1 - 2007/9/1

N2 - BACKGROUND: Endoscopic retrograde cholangiopancreatography (ERCP) is a well established diagnostic and therapeutic tool in adult and pediatric patients. Because of its inherent risks we analysed our series in an attempt to better define the diagnostic and therapeutic roles of ERCP and its effectiveness in children.METHODS: All ERCPs performed in our department during a 10-year period in patients age 14 years and under were reviewed retrospectively. Indications, diagnostic findings, therapeutic interventions and final outcome were documented.RESULTS: A total of 61 procedures were performed on 47 patients whose median age was 8.56 years. ERCP was successful in 53 of 61 interventions (89%) with a complication rate of 6%. Thirty patients underwent diagnostic ERCP. In these a pathological diagnosis was established in 57%. In patients without morphological changes in ultrasound or magnet resonance imaging ERCP failed to set diagnosis too. Seventeen patients had therapeutic ERCPs. All of these interventions were performed with similar or better outcome than in adults.CONCLUSION: Indications for diagnostic ERCP are morphologic biliary or pancreatic duct disorders, but only where higher resolution imaging is necessary for therapeutic decisions. Without morphologic changes on ultrasound or magnetic resonance imaging we rarely see any indication for diagnostic ERCP. Efficacy of therapeutic ERCP in childhood is similar or even better to that in adults. Prognoses are directly dependent from the basic disease of the patient.

AB - BACKGROUND: Endoscopic retrograde cholangiopancreatography (ERCP) is a well established diagnostic and therapeutic tool in adult and pediatric patients. Because of its inherent risks we analysed our series in an attempt to better define the diagnostic and therapeutic roles of ERCP and its effectiveness in children.METHODS: All ERCPs performed in our department during a 10-year period in patients age 14 years and under were reviewed retrospectively. Indications, diagnostic findings, therapeutic interventions and final outcome were documented.RESULTS: A total of 61 procedures were performed on 47 patients whose median age was 8.56 years. ERCP was successful in 53 of 61 interventions (89%) with a complication rate of 6%. Thirty patients underwent diagnostic ERCP. In these a pathological diagnosis was established in 57%. In patients without morphological changes in ultrasound or magnet resonance imaging ERCP failed to set diagnosis too. Seventeen patients had therapeutic ERCPs. All of these interventions were performed with similar or better outcome than in adults.CONCLUSION: Indications for diagnostic ERCP are morphologic biliary or pancreatic duct disorders, but only where higher resolution imaging is necessary for therapeutic decisions. Without morphologic changes on ultrasound or magnetic resonance imaging we rarely see any indication for diagnostic ERCP. Efficacy of therapeutic ERCP in childhood is similar or even better to that in adults. Prognoses are directly dependent from the basic disease of the patient.

KW - Adolescent

KW - Age Factors

KW - Biliary Tract Diseases/diagnosis

KW - Child

KW - Child, Preschool

KW - Cholangiopancreatography, Endoscopic Retrograde/adverse effects

KW - Female

KW - Humans

KW - Infant

KW - Magnetic Resonance Imaging

KW - Male

KW - Pancreatic Diseases/diagnosis

KW - Pancreatic Ducts/diagnostic imaging

KW - Retrospective Studies

KW - Ultrasonography

U2 - 10.1055/s-2006-942196

DO - 10.1055/s-2006-942196

M3 - SCORING: Journal article

C2 - 17763292

VL - 219

SP - 271

EP - 276

JO - KLIN PADIATR

JF - KLIN PADIATR

SN - 0300-8630

IS - 5

ER -