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ORIGINAL ARTICLE
Korean J Pediatr 1997 December;40(12) :1681-1691.
Diagnostic and Therapeutic Efficacy of Endoscopic Retrograde Cholangiopancreatography in Children
Kyung Mo Kim (Kim KM)1, Ho Soon Choi (Choi HS)1, Sung Koo Lee (Lee SK)1, Myung Hwan Kim (Kim MH)1, Chong Hyun Yoon (Yoon CH)2, Dong Myung Lee (Lee DM)3
1Department of Internal Medicine, Asan Medical Center, College of Medicine University of Ulsan, Seoul, Korea
2Department of Diagnostic Radiology, Asan Medical Center, College of Medicine University of Ulsan, Seoul, Korea
3Department of Anesthesiology, Asan Medical Center, College of Medicine University of Ulsan, Seoul, Korea
Copyright © 1997 by The Korean Pediatric Society
ABSTRACT
Purpose : Endoscopic retrograde cholangiopancreatography(ERCP) may provide more definite diagnosis, preoperative guidance, and endoscopic therapy in many children with known or suspected disorders of the pancreas and biliary tract. But the reports about the ERCP in children are rare, so this study is conducted to evaluate the indication, efficacy and safety of the ERCP in children. Methods : Twenty nine ERCPs in 19 children were included in this study from July, 1994 to Dec, 1996. The children were nine boys and ten girls and their mean age was 6.9 years old(24 months-14 years). The examination was performed in 16 children under general anesthesia while the other 3 adolescent under conscious sedation with Olympus JF or JF1T duodenoscope. We evaluated the indication, efficacy and complication of the ERCPs. Results : All cannulations were successful except one and endoscopic sphincterotomy (EST) was done in 12 children. Among 19 children, we could confirm the clinical diagnosis in 6, add the additional information in 5, revise the diagnosis in 4(operation guidance in 3), but give no diagnosis in 4 even after ERCP. The diagnosis after ERCPs are choledochol cyst(4), choledochocele(1), bile duct stricture(1), GB and CBD stone(1), pancreatitis with biliary sludge(5), chronic pancreatitis(2) and pancreatic fistula(1). We could achieve therapeutic goal in 8 children after therapeutic ERCP in 11 children. As complications of ERCP, pancreatitis developed in 2 children, moderate delayed hemorrhages requiring transfusion in 2, retroduodenal perforation in 1 and cholangitis in 1 child. No fatality was observed and all complications improved after supportive cares. Most of the complications developed after EST. Conclusions : All ERCPs were successful, although most of them were done under general anesthesia. In this study we could conclude that ERCP may provide more definite diagnosis, preoperative guidance, and endoscopic therapy in many children with known or suspected disorders of the pancreas and biliary tract. But special care should be paid especially after EST.
Keywords: Endoscopic retrograde cholangiopancreatography | Therapeutic ERCP | Child | Indication | Complication
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