Endoscopic therapy of biliary and pancreatic disorders in children

Although many reports in the literature describe the use of endoscopic retrograde cholangiopancreatography (ERCP) in children, few mention the therapeutic application of the technique in treating pediatric patients with pancreatic or biliary pathology. We report here on our two-year experience, consisting of 42 ERCPs conducted in 25 patients for a variety of pancreaticobiliary indications. Ages ranged from 22 months to 19 years. Five patients had normal studies, the remainder were diagnosed with a variety of pancreatic and or biliary anomalies. Seventeen patients had therapeutic interventions consisting of sphincterotomy (n = 12), dilation (n = 6), or stent placement (n = 9), with many of these procedures being done in combination. Five patients had mild complaints of abdominal pain or vomiting immediately after ERCP, but no major technical or medical complications were encountered. We find that therapeutic ERCP can be safely performed in children, but only by highly experienced endoscopists familiar with these specialized procedures.