Complications of endoscopic retrograde cholangiopancreatography in children with pancreaticobiliary diseases

Abstract

Objective To study the incidence, influencing factors and corresponding treatment of complications of endoscopic retrograde cholangiopancreatography (ERCP) in children with pancreaticobiliary diseases. Method Clinical data of 172 children aged under 16 years with pancreaticobiliary diseases receiving ERCP between January 2008 and December 2017 in Hangzhou First People′s Hospital were studied retrospectively. Anesthesia type, diagnosis, therapeutic methods and postoperative complications were analyzed. Results A total of 375 ERCP procedures were performed on 172 patients, among whom there were 210 cases (56.0%) of bile duct diseases and 245 (65.3%) pancreatic diseases. Dissection of pancreatic duct and biliary duct, calculus removal, insertion of endoprosthesis and drainage of pancreatic duct or biliary duct were performed. The success rate of ERCP was 99.5% (373/375). The incidence of complications was 6.7% (25/375) including 13 cases (3.5%) of post-ERCP pancreatitis, 8 cases (2.1%) of bleeding, and 6 cases (1.6%) of postoperative cholangitis. All the complications were cured. No severe pancreatitis, perforation or ERCP-related death occured. The first ERCP procedure and repeated cannulations were the risk factors of post-ERCP pancreatitis (P<0.05). Children had higher risk of post-ERCP bleeding after endoscopic sphincterotomy (P<0.05). Conclusion The incidence of post-ERCP complications in children is similar to that of adults and is related to therapeutic methods. More attention and timely treatment should be given to those children. ERCP can be effectively and safely for children operated by an experienced endoscopic physician with appropriate therapeutic methods. Key words: Cholangiopancreatography, endoscopic retrograde; Pancreatic diseases; Bile duct diseases; Child; Postoperative complications