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DOI: 10.1055/s-0040-1705035
SAFETY OF ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY IN PEDIATRIC POPULATION: A MULTICENTER STUDY
Publication History
Publication Date:
23 April 2020 (online)
Aims Endoscopic retrograde cholangiopancreatography (ERCP) has an important role in pediatric pancreaticobiliary diseases. The aims of this retrospective multicenter study were to assess the technical success and adverse events of ERCPs in children in French and Belgian centers.
Methods All children aged from one day to seventeen years old who underwent ERCP between January 2008 and March 2019 in 15 tertiary care hospitals were retrospectively included.
Results 271 children underwent 470 ERCP. Median age at intervention was 10.9 years. Multiple ERCP were performed on 30% patients (81/271). ERCP were therapeutic in 90% (423/470) and diagnostic only, in case of neonatal cholestasis, in 10%. Proportions of biliary and pancreatic indications were 63% and 37% respectively. Most common biliary indication was choledocholithiasis and most common pancreatic indication was chronic pancreatitis. Biliary cannulation was successful in 92% of cases (270/294), pancreatic cannulation in 96% (169/176) and planned therapeutic procedure was successful in 91% (388/423). The overall complication rate was 19% (65/340). Most common complication was post-ERCP pancreatitis (PEP) in 12% (40/340) and sepsis in 5% (18/340). In multivariate analysis, pancreatic stent removal was protective against PEP
(OR 0.066; 95% CI: 0.005;0.826, p=0.035) and sepsis was associated with liver transplantation history (OR 8.64, 95% CI: 1.648;45.305, p=0.011). Five patients had post-ERCP hemorrhage and two had intestinal perforation. All complications were successfully managed with supportive medical care. There was no procedure-related mortality. There was no post sphincterotomy cholangiocarcinoma reported nor cancer radio-induced reported throughout the study period.
Conclusions Our cohort demonstrates that ERCP can be performed safely with high success rates in many pancreaticobiliary diseases of children. The rate of adverse events was similar to previous reports and no serious adverse events occurred. The beneficial impact of ERCP in this large multicentric pediatric cohort is highlighted.
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