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In pediatrics (aged 3-12 years of age), ERCP can be safely performed using standard duodenoscope under Monitored Anesthesia Care with positive post treatment outcomes.
A study published in the “Journal of Pediatric Endoscopy Surgery” depicted that in pediatric patients, endoscopic retrograde cholangiopancreatography (ERCP) procedure can be safely carried out under Monitored Anesthesia Care (MAC) utilizing adult duodenoscope. This retrospective chart review aimed to evaluate the efficacy and safety of ERCP procedure performed under MAC using standard duodenoscope in pediatric population.
Patients up to 12 years of age who had undergone ERCP in the last 2 years were incorporated in the study. Demographic data with intra-procedural details, diagnoses, completion of procedure, indications, interventions and complications were noted. Overall, 36 patients (ranging 3–12 years, mean age 8.3 ± 2.6 years, mean weight 24.5 ± 9.0 kg) were allocated to perform 53 procedures. Indications comprised 72.2% chronic or recurrent pancreatitis (n = 26), 5.6% acute pancreatitis (n = 2), 5.6% abdominal pain (n = 2), 2.8% choledochal cyst (n = 1 ), 11.1% choledocholithiasis (n = 4), 5.6% biliary structure (n = 2), 5.6% cholestatic liver function test patterns (n = 2) and 2.8% cholangitis (n = 1).
All patients achieved successful endoscopic cannulation of any duct, whereas in 33 patients (91.7%), cannulation of desired duct and procedure completion were achieved. Notably, 69.8% of therapeutic procedures and 30.2% of diagnostic procedures were carried out. In 11.1% patients (n = 4), over all complications were recorded. In 5.6% patients (n = 2), mild intra-procedural bleeding and mild post-procedural pain were most commonly reported. Hence, therapeutic and diagnostic ERCP is proven to be effective and safe in pediatric patients when performed with standard duodenoscopes.
Journal of Pediatric Endoscopic Surgery
The safety and efficacy of ERCP in the pediatric patients up to 12 years of age with standard duodenoscope by adult gastroenterologists
M. Salih et al.
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