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The safety and efficacy of ERCP in the pediatric patients up to 12 years of age with standard duodenoscope by adult gastroenterologists

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Abstract

Purpose

Although endoscopic retrograde cholangiopancreatography (ERCP) has well-established efficacy in adult population, there are limited data available regarding its outcomes and complications in children, especially from countries where pediatric gastroenterology is not well established. We aim to determine the safety and efficacy of ERCP performed under Monitored Anesthesia Care (MAC) in pediatric population by adult gastroenterologists with standard duodenoscope at tertiary care referral center in Pakistan.

Methods

Retrospective chart review was conducted for all patients up to 12 years of age who had undergone ERCP in the last 2 years. Demographic data along with indications, intra-procedural details, completion of procedure, diagnoses, interventions and complications were recorded.

Results

Fifty-three procedures were performed in 36 patients (mean age 8.3 ± 2.6 years, range 3–12 years). Mean weight of the patients was 24.5 ± 9.0 kg. Indications included recurrent or chronic pancreatitis (26, 72.2%), acute pancreatitis (2, 5.6%), abdominal pain (2, 5.6%) choledochal cyst (1, 2.8%), choledocholithiasis (4, 11.1%), biliary stricture (2, 5.6%), cholestatic LFT patterns (2, 5.6%) and cholangitis (1, 2.8%). Endoscopic cannulation of any duct was achieved in all patients while desired duct cannulation and completion of procedure were achieved in 33 patients (91.7%). 69.8% procedures were therapeutic while 30.2% were diagnostic. Over all complications were observed in 4 (11.1%) patients, with minor intra-procedural bleeding and mild post-procedural pain being the most common (2, 5.6%).

Conclusion

ERCP can be safely performed in pediatric population using adult duodenoscope under MAC with good outcomes and complication rates.

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Funding

The authors have no relevant financial or non-financial interests to disclose.

Author information

Authors and Affiliations

  1. Department of Hepatology, Quaid-e-Azam International Hospital, Islamabad, Pakistan

    M. Salih, Y. Abbas & N. J. Shah

  2. Department of Internal Medicine, University of South Alabama University Hospital, Mobile, AL, USA

    H. Z. Malik

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  1. M. Salih
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  2. H. Z. Malik
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  3. Y. Abbas
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  4. N. J. Shah
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Contributions

Study conception + design—MS. Data acquisition—HM, YA, and NS. Analysis + data interpretation—MS and HM. Drafting of the manuscript—MS, HM, YA, and NS. Critical revision—MS and HM.

Corresponding author

Correspondence to H. Z. Malik.

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Conflict of interest

The authors declare that they have no conflict of interest.

Consent to publish

The study was conducted in compliance with the Declaration of Helsinki.

Additional information

The abstract was presented at the APASL (The Asian Pacific Association for the Study of the Liver) on December 8 2019 in Islamabad, Pakistan.

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Salih, M., Malik, H.Z., Abbas, Y. et al. The safety and efficacy of ERCP in the pediatric patients up to 12 years of age with standard duodenoscope by adult gastroenterologists. J Ped Endosc Surg 4, 117–122 (2022). https://doi.org/10.1007/s42804-022-00148-7

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  • DOI: https://doi.org/10.1007/s42804-022-00148-7

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