title: Endoscopic retrograde cholangiopancreatography is useful and safe in children.
abstract: OBJECTIVE
  Endoscopic retrograde cholangiopancreatography (ERCP) is a recognized diagnostic and therapeutic tool in the adult population. Its use in children has been more common in the last years. There are little data on safety and usefulness of that procedure in children. The aim of this study was to review the experience with ERCP in a tertiary university center dedicated to children.
  
  
  METHODS
  We conducted a retrospective chart review of patients seen at the Centre Hospitalier Universitaire Ste-Justine (Montreal, Quebec, Canada) who had undergone an ERCP between September 1990 and July 2007. Data on demographics, diagnosis, anesthesia type, treatments, and complications were collected.
  
  
  RESULTS
  Thirty-eight ERCPs were performed on 29 patients. There were 21 girls (72%), and median age at time of procedure was 10.3 years old (range, 3-17 years). Most had only one procedure performed. Two children had 2 interventions, and 1 child with papillary stenosis had 8 interventions linked to stent treatment. The ampulla was cannulated, and the procedure was successfully completed in 97% (37/38) of cases. General anesthesia and sedation were performed in 74% and 26% of procedures, respectively. Indications for ERCP were 29 recurrent or chronic pancreatitis (76%), 8 common bile duct obstructions (21%), and 1 choledochal cyst (3%). Endoscopic treatment was done in 29% of cases. The complication rate was 13.5%, and 4 clinical acute pancreatitis resolved with conservatory treatment. No severe pancreatitis, perforation, or bleeding was noted. Of the patients, 79% had their follow-up at the Centre Hospitalier Universitaire Ste-Justine for a median length of 43 months (range, 1-53 months).
  
  
  CONCLUSIONS
  Endoscopic retrograde cholangiopancreatography is used as a diagnostic and therapeutic procedure in children with a complication rate similar to that seen in adults. The need for general anesthesia is much more frequent with children. When performed by well-trained endoscopists, ERCP is useful and safe in children.
authors.affiliation: Department of Pediatric Surgery, Centre Hospitalier Universitaire Ste-Justine, Montreal, Quebec, Canada.
authors.forename: Catherine
authors.initials: C
authors.lastname: Paris
authors.forename: Jimmy
authors.initials: J
authors.lastname: Bejjani
authors.forename: Mona
authors.initials: M
authors.lastname: Beaunoyer
authors.forename: Alain
authors.initials: A
authors.lastname: Ouimet
mesh_terms: D000293:Adolescent; D001649:Bile Duct Diseases / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000009:adverse effects / Q000379:methods; D005260:Female; D042882:Gallstones / Q000601:surgery; D006801:Humans; D008297:Male; D010195:Pancreatitis / Q000601:surgery*; D050500:Pancreatitis, Chronic / Q000601:surgery; D011792:Quebec; D012008:Recurrence; D012189:Retrospective Studies; D012449:Safety; D016896:Treatment Outcome