Endoscopy 2019; 51(04): S74
DOI: 10.1055/s-0039-1681389
ESGE Days 2019 oral presentations
Friday, April 5, 2019 17:00 – 18:30: ERCP cannulation 1 Panorama Hall
Georg Thieme Verlag KG Stuttgart · New York

ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY IN CHILDREN

TL Åvitsland
1   Gastroenterology, Vestre Viken Trust, Bærum Hospital, Gjettum, Norway
2   Gastroenterology, Oslo University Hospital, Rikshospitalet, Oslo, Norway
,
L Aabakken
2   Gastroenterology, Oslo University Hospital, Rikshospitalet, Oslo, Norway
› Author Affiliations
Further Information

Publication History

Publication Date:
18 March 2019 (online)

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Aims:

We wanted to examine our results regarding safety and outcomes in our paediatric patients at Oslo University Hospital.

Methods:

Patients younger than 18 years who underwent ERCP between April 1999 and November 2017 were identified using procedure codes. Medical records were examined. Descriptive statistics were prepared.

Results:

244 procedures in 158 patients were performed. 56 of these were in 53 infants (age ≤1 year). The remaining 188 procedures were in 102 children. Mean age was 8.8 years. The youngest patient was 8 days old. The smallest infant weighing 2.9 kg. In 19 (7.8%) procedures one failed to cannulate, in 6 infants and 13 children.

The main indication in infants was as part of the diagnostic work-up to confirm presence of biliary atresia (n = 38), and findings at ERCP suggested biliary atresia in 21 cases of which 17 underwent surgery with portoenterostomy, two underwent liver transplantation, one underwent laparoscopic exploration that excluded biliary atresia, and in one patient other liver disease were found. Six of the procedures (10.7%) were therapeutic.

In children the main indication was biliary stenosis (n = 46), investigation of primary sclerosing cholangitis (n = 32), choledocholithiasis (n = 20), and removal/replacement of biliary/pancreatic stent (n = 23), pancreatitis (n = 9). 116 (61.7%) of the procedures were therapeutic; sphincterotomy in 39, dilation in 34, stenting in 20, stent removal in 17, and placement of a nasobiliary drain in 6.

Complications were uncommon in infants (4%); two episodes of infection treated with antibiotics were registered. In children complications were seen in 22 (12.7%); post-ERCP pancreatitis in 18 (10.4%), cholangitis in two, sphincterotomy bleed in one, and perforation in one.

Conclusions:

Our series of ERCP procedures includes 56 procedures in infants, which is one of the largest series presented. Complications in infants are rare, only 4%, and none post-ERCP pancreatitis were seen. 10.4% of children experienced post-ERCP pancreatitis.