title: Diagnostic and Therapeutic Roles of Endoscopic Ultrasound in Pediatric Pancreaticobiliary Disorders.
abstract: OBJECTIVE
  The diagnostic role of endoscopic ultrasound (EUS) in children has only recently been demonstrated, and that also to a lesser extent than in adults. Data on the technique's therapeutic indications remain scarce. We therefore sought to evaluate diagnostic and interventional EUS indications, safety, and impact in children with pancreaticobiliary disorders.
  
  
  METHODS
  We retrospectively reviewed our single pediatric center records, covering a 14-year period.
  
  
  RESULTS
  From January 2000 to January 2014, 52 EUS procedures were performed in 48 children (mean age: 12 years; range: 2-17 years) with pancreaticobiliary disorders for the following indications: suspected biliary obstruction (n = 20/52), acute/chronic pancreatitis (n = 20), pancreatic mass (n = 3), pancreatic trauma (n = 7), and ampullary adenoma (n = 2). EUS was found to have a positive impact in 51 of 52 procedures, enabling us to avoid endoscopic retrograde cholangiopancreatography (ERCP) (n = 13 biliary; n = 6 pancreatic), focusing instead on endotherapy (n = 7 biliary; n = 14 pancreatic) or reorienting therapy toward surgery (n = 7). EUS-guided fine-needle aspiration was carried out on 12 patients for pancreatic tumor (n = 4), pancreatic cyst fluid analysis (n = 4), autoimmune pancreatitis (n = 2), and suspicion of biliary tumor (n = 2). A total of 13 therapeutic EUS procedures (11 children) were conducted, including 9 combined EUS-ERCP procedures (7 children, mean age: 8 years, range: 4-11 years), 3 EUS-guided pseudocyst drainage (2 children), and 1 EUS-guided transgastric biliary drainage.
  
  
  CONCLUSIONS
  Our study reports on a large pediatric EUS series for diagnostic and therapeutic pancreaticobiliary disorders, demonstrating the impact of diagnostic EUS and affording insights into novel EUS and combined EUS-ERCP therapeutic applications. We suggest considering EUS as a diagnostic and therapeutic tool in the management of pediatric pancreaticobiliary diseases.
authors.affiliation: *Department of Pediatric Gastroenterology, Hepatology and Nutrition †Department of Hepatogastroenterology ‡Pediatric Surgery and Transplantation Unit §Department of Pediatric Anesthesiology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels ||Department of Pathology, Centre Hospitalier Universitaire Dinant-Godinne, Yvoir, Belgium.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Scheers
authors.forename: Meltem
authors.initials: M
authors.lastname: Ergun
authors.forename: Tarik
authors.initials: T
authors.lastname: Aouattah
authors.forename: Hubert
authors.initials: H
authors.lastname: Piessevaux
authors.forename: Ivan
authors.initials: I
authors.lastname: Borbath
authors.forename: Xavier
authors.initials: X
authors.lastname: Stephenne
authors.forename: Catherine
authors.initials: C
authors.lastname: De Magnée
authors.forename: Raymond
authors.initials: R
authors.lastname: Reding
authors.forename: Etienne
authors.initials: E
authors.lastname: Sokal
authors.forename: Francis
authors.initials: F
authors.lastname: Veyckemans
authors.forename: Birgit
authors.initials: B
authors.lastname: Weynand
authors.forename: Pierre H
authors.initials: PH
authors.lastname: Deprez
mesh_terms: D000293:Adolescent; D001660:Biliary Tract Diseases / Q000175:diagnosis* / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D042883:Choledocholithiasis / Q000175:diagnosis / Q000628:therapy; D002779:Cholestasis / Q000175:diagnosis / Q000628:therapy; D003137:Common Bile Duct Diseases / Q000175:diagnosis / Q000628:therapy; D019160:Endosonography / Q000009:adverse effects; D005260:Female; D006801:Humans; D008297:Male; D010179:Pancreas / Q000293:injuries; D010182:Pancreatic Diseases / Q000175:diagnosis* / Q000628:therapy*; D010195:Pancreatitis / Q000175:diagnosis / Q000628:therapy; D010372:Pediatrics; D012189:Retrospective Studies