A newly developed small-caliber videoduodenoscope for endoscopic retrograde cholangiopancreatography in children.
BACKGROUND
In neonates and younger children, the procedure of endoscopic retrograde cholangiopancreatography (ERCP) is now optimally performed using a small-caliber fiberoptic duodenoscope. However, there have been no reports on a specially designed videoduodenoscope for pediatric ERCP.


OBJECTIVE
To evaluate performance and clinical usefulness of a newly developed small-caliber videoduodenoscope for ERCP in children.


METHODS
We have developed a side-viewing videoduodenoscope with a 8.0-mm outside diameter of the tip and a 2.0-mm diameter instrument channel (Olympus PJF-240). In a total of 10 pediatric patients aged 11 months to 15 years (mean age, 6.1 years) who underwent ERCP using this videoduodenoscope, its feasibility was evaluated. Clinical diagnoses included pancreatitis (n = 4), choledochal cyst (n = 3), sclerosing cholangitis (n = 1), cholecystitis (n = 1), and choledocholithiasis (n = 1). In all patients, ERCP was done in the standard fashion under general anesthesia.


RESULTS
ERCP was successful in 9 of 10 patients (90%). In the procedure, entering the descending duodenum was smooth and positioning the papilla on the endoscopic image was proper. In an 11-month-old infant, extraction of biliary stones by endoscopic balloon dilation was successfully done. Post-ERCP complications, including a significant increase of serum amylase levels, were not reported in any patients.


CONCLUSIONS
This new videoduodenoscope has a potential for ERCP in all age groups of children.
Kato
Seiichi
S
Department of Pediatrics, Tohoku University School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai 980-8574, Japan. skato@ped.med.tohoku.ac.jp
Kamagata
Shoichiro
S
Asakura
Tohru
T
Ozawa
Kyoko
K
Nio
Masaki
M
Ohi
Ryoji
R
Munakata
Mitsutoshi
M
Iinuma
Kazuie
K
D000293:Adolescent; D001660:Biliary Tract Diseases / Q000000981:diagnostic imaging; D002648:Child; D002675:Child, Preschool; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000295:instrumentation*; D015529:Choledochal Cyst / Q000000981:diagnostic imaging; D020698:Duodenoscopes; D004867:Equipment Design; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D010182:Pancreatic Diseases / Q000000981:diagnostic imaging; D014741:Video Recording