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ABSTRACTS: Poster Session Abstracts

P0816 ENDOSCOPIC THERAPY OF HEPATOBILIARY AND PANCREATIC DISORDERS IN CHILDREN

El Khoury, M. G.1; Liguory, C.2; Lefebvre, J.2; Mougenot, J.3

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Journal of Pediatric Gastroenterology and Nutrition: June 2004 - Volume 39 - Issue - p S367
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Introduction: ERCP is increasingly used as a therapeutic tool in children. We present our experience with the technique and its indications and complications.

Methods: We retrospectively reviewed the charts of 31 pediatric patients who were referred to the Clinique de L’Alma for therapeutic ERCP between 1994 and 2003.

Results: Sex ratio is 13 boys for 18 girls. Median age at time of procedure is 9 years (2y–16y). A total of 44 ERCPs were performed with 1 to 5 procedures performed for each patient. The procedures were also diagnostic, following imaging techniques (US, MRI). All were done under general anesthesia with tracheal intubation.

ERCP was performed for biliary obstruction in 13 cases: 10 patients with choledocolithiasis, one patient with ampullary stenosis from HIV associated cholangitis, one patient with a papillary tumor and one patient with post EPT stenosis. Sphincterotomy was performed with stent placement and stone extraction when indicated. All procedures were successful

Two patients had ERCP for biliary leak following liver transplantation. Biliary stent placement was successful in 1 case, followed 3 months later by extraction and stenosis dilation.

Five patients benefited from ERCP after blunt pancreatic trauma. Transgastric pseudocyst stent drainage was successful in 3 of 4 attempts. Stent placement for pancreatic ductal disruption was successful in 2 of 3 attempts.

Finally 11 patients had ERCP for recurring pancreatitis. We identified pancreas divisum in 3 cases and pancreatic duct stenosis in 2 cases, with chronic pancreatitis changes in all. Pancreatic sphincterotomy was performed in all cases with stent placement in 5.

No post-ERCP pancreatitis was documented in patients with biliary disease. In children with previous pancreatic disease, immediate post interventional course was not aggravated. One case was complicated with duodenal perforation which required conservative treatment. One patient developed pancreatic duct stenosis after stent placement for recurring pancreatitis.

Conclusion: We present our experience of endoscopic therapy of biliary and pancreatic disorders. The procedure is minimally invasive compared to surgery. Success rate is high and the complications rate is low. However adequate competence and training are required for optimal performance.

© 2004 Lippincott Williams & Wilkins, Inc.