Keane MG, et al. - Here, researchers described the paediatric ERCP and endoscopic ultrasound (EUS) experience from a large tertiary referral hepatopancreaticobiliary (HPB) centre. When performed in high volume HPB centres, ERCP and EUS in children and adolescents had high technical success rates and low rates of adverse events.

Methods

• The researchers included all patients <18 years undergoing an ERCP or EUS between January 1992-December 2014.
• They recorded indications for the procedure, rates of technical success, procedural adverse events and reinterventions in all cases.

Results

• A total of 111 procedures (87 ERCPs and 24 EUS) were performed on 90 children.
• In this study, 53% (48) were female with a median age of 14 years (range: 3 months - 17 years).
• During this study, procedures were performed under general anaesthesia (n = 48) or conscious sedation (n = 63).
• Chronic or recurrent pancreatitis and biliary obstruction were identified as common indications for ERCP.
• With a median ASA grade of 2 (range 1–4), patients frequently had multiple comorbidities.
• Biliary or pancreatic sphincterotomy, common bile duct or pancreatic duct stone removal, biliary or pancreatic stent insertion, EUS-guided fine needle aspiration and endoscopic transmural drainage of pancreatic fluid collections were the therapeutic procedures that were performed.
• Following ERCP, no adverse events were reported.
• However, there was 1 complication requiring surgery following EUS guided cystenterostomy.