title: Endoscopic retrograde cholangiopancreatography in children and adolescents.
abstract: OBJECTIVE
  Endoscopic retrograde cholangiopancreatography (ERCP) is becoming a more frequently used diagnostic and therapeutic tool in children. We sought to determine the indications, feasibility, safety, and effect on patient management of ERCP in pediatric patients of varying age.
  
  
  METHODS
  All ERCPs performed during a 4-year period in patients aged 18 years or less at an academic hospital were retrospectively reviewed. The indications, type of anesthesia administered, type of duodenoscope used, diagnostic findings, therapeutic interventions, complication rate, and effect on management were compared between children (age 0-12 years) and adolescents (age 13-18 years).
  
  
  RESULTS
  A total of 53 procedures were performed in 43 patients whose median age was 13.5 years. ERCP was successful in 50 of 53 cases (94%) with a complication rate of 6%. Endoscopic therapy was provided in 24 of 53 cases (45%). Compared with adolescents (n = 28), children (n = 25) were more likely to receive general anesthesia (96% vs. 29%; P < 0.001) and undergo ERCP with a pediatric duodenoscope (0% vs. 40%). ERCP affected management in 73% of cases, equally in both groups.
  
  
  CONCLUSIONS
  ERCP is a successful and safe diagnostic and therapeutic modality in a variety of pancreatobiliary disorders that directly affects management in children of all ages.
authors.affiliation: Division of Gastroenterology, University Hospitals of Cleveland, Case Western Reserve University School of Medicine, Cleveland, Ohio 44106-5066, USA.
authors.forename: Patrick R
authors.initials: PR
authors.lastname: Pfau
authors.forename: Gisela G
authors.initials: GG
authors.lastname: Chelimsky
authors.forename: Margaret F
authors.initials: MF
authors.lastname: Kinnard
authors.forename: Michael V
authors.initials: MV
authors.lastname: Sivak
authors.forename: Richard C K
authors.initials: RC
authors.lastname: Wong
authors.forename: Gerard A
authors.initials: GA
authors.lastname: Isenberg
authors.forename: Priya
authors.initials: P
authors.lastname: Gurumurthy
authors.forename: Amitabh
authors.initials: A
authors.lastname: Chak
mesh_terms: D000293:Adolescent; D000768:Anesthesia, General; D001660:Biliary Tract Diseases / Q000175:diagnosis* / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000379:methods; D003937:Diagnosis, Differential; D020698:Duodenoscopes; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D010182:Pancreatic Diseases / Q000175:diagnosis* / Q000628:therapy*; D011183:Postoperative Complications; D012189:Retrospective Studies; D012449:Safety; D016896:Treatment Outcome