Endoscopy 2021; 53(06): 586-594
DOI: 10.1055/a-1209-0155
Original article

Safety of endoscopic retrograde cholangiopancreatography in the pediatric population: a multicenter study

Clémence Mercier
 1  Department of Pediatric Gastroenterology Hepatology and Nutrition, Children's Hospital of Nancy, Nancy, France
,
Mathieu Pioche
 2  Department of Endoscopy and Gastroenterology, Hôpital Edouard Herriot, Lyon, France
,
Eliane Albuisson
 3  CHRU-Nancy, DRCI, Département MPI, Unité de Méthodologie, Data management et Statistique UMDS, Nancy, France
,
Thierry Ponchon
 2  Department of Endoscopy and Gastroenterology, Hôpital Edouard Herriot, Lyon, France
,
Jean-Michel Gonzalez
 4  Department of Digestive Endoscopy, Aix-Marseille Université, AP-HM, Hôpital Nord, Marseille, France
,
Marc Barthet
 4  Department of Digestive Endoscopy, Aix-Marseille Université, AP-HM, Hôpital Nord, Marseille, France
,
Isabelle Boytchev
 5  Gastroenterology Department, Kremlin-Bicêtre University Hospital, Paris, France
,
Geoffroy Vanbiervliet
 6  Gastroenterology Department, University Hospital, Nice, France
,
Clement Fortier Beaulieu
 6  Gastroenterology Department, University Hospital, Nice, France
,
Frederic Prat
 7  Department of Gastroenterology, Cochin Hospital, Paris, France
,
Arthur Belle
 7  Department of Gastroenterology, Cochin Hospital, Paris, France
,
Julien Branche
 8  Gastroenterology Department, Claude Huriez Hospital, Lille, France
,
Phillipe Grandval
 9  Hepatogastroenterology Department, AP-HM, Hôpital La Timone, Marseille, France
,
Jean-Christophe Valats
10  Department of Endoscopy and Gastroenterology, Lapeyronie Hospital, Montpellier, France
,
Franz Rudler
10  Department of Endoscopy and Gastroenterology, Lapeyronie Hospital, Montpellier, France
,
Timothee Wallenhorst
11  Department of Gastroenterology, University Hospital of Rennes, Pontchaillou, France
,
Stephane Koch
12  Department of Gastroenterology, University Hospital of Besançon, Besançon, France
,
Aurélie Comte
13  Department of Pediatric Hepatology, Gastroenterology and Nutrition, CHU Besançon, Besançon, France
,
Nicolas Williet
14  Department of Hepato-gastro-enterology, University Hospital of Saint-Etienne, Saint-Etienne, France
,
Nicolas Musquer
15  Digestive Endoscopy Department, Nantes University Hospital, Nantes, France
,
Emmanuel Coron
15  Digestive Endoscopy Department, Nantes University Hospital, Nantes, France
,
Aline Derosiere
16  Department of Gastroenterology, Amiens University Hospital, Université de Picardie Jules Verne, Amiens, France
,
Jean-Phillippe Le Mouel
16  Department of Gastroenterology, Amiens University Hospital, Université de Picardie Jules Verne, Amiens, France
,
Marion Schaefer
17  Department of Endoscopy and Hepatogastroenterology, Regional University Hospital of Nancy, Nancy, France
,
Caroline Chabot
 1  Department of Pediatric Gastroenterology Hepatology and Nutrition, Children's Hospital of Nancy, Nancy, France
,
Isabelle Scheers
18  Department of Pediatric Gastroenterology and Hepatology, Cliniques Universitaires Saint-Luc, Brussels, Belgium
,
Pierre H. Deprez
19  Department of Hepatogastroenterology, Cliniques Universitaires Saint-Luc, Brussels, Belgium
,
Jean-Baptiste Chevaux
17  Department of Endoscopy and Hepatogastroenterology, Regional University Hospital of Nancy, Nancy, France
› Author Affiliations


Abstract

Introduction The aims of this retrospective multicenter study were to assess the technical success and adverse events of endoscopic retrograde cholangiopancreatography (ERCP) procedures in children in French and Belgian centers.

Methods All children aged 1 day to 17 years who underwent ERCP between January 2008 and March 2019 in 15 tertiary care hospitals were retrospectively included.

Results 271 children underwent 470 ERCP procedures. Clinical long-term follow-up was available for 72 % of our patients (340/470 procedures). The median age at intervention was 10.9 years. ERCP was therapeutic in 90 % (423/470) and diagnostic in cases of neonatal cholestasis in 10 % of the patients. The most common biliary indication was choledocholithiasis; the most common pancreatic indication was chronic pancreatitis. Biliary cannulation was successful in 92 % of cases (270/294); pancreatic cannulation in 96 % of cases (169/176); and planned therapeutic procedures in 92 % of cases (388/423). The overall complication rate was 19 % (65/340). The most common complication was post-ERCP pancreatitis (PEP) in 12 % of cases (40/340) and sepsis in 5 % (18/340). On univariate analyses, pancreatic stent removal was protective against PEP (odds ratio [OR] 0.1, 95 % confidence interval [CI] 0.01 – 0.75; P = 0.03), and sepsis was associated with history of liver transplantation (OR 7.27, 95 %CI 1.7 – 31.05; P = 0.01). Five patients had post-ERCP hemorrhage and two had intestinal perforation. All complications were managed with supportive medical care. There was no procedure-related mortality.

Conclusion Our cohort demonstrates that ERCP can be performed safely with high success rates in many pancreaticobiliary diseases of children. The rate of adverse events was similar to that in previous reports.



Publication History

Received: 26 January 2020

Accepted: 29 June 2020

Publication Date:
29 June 2020 (online)

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