Usefulness and safety of endoscopic retrograde cholangiopancreatography in children with pancreaticobiliary maljunction.
BACKGROUND
To assess the diagnostic ability and safety of endoscopic retrograde cholangiopancreatography (ERCP) in in-depth preoperative examination of children patients with pancreaticobiliary maljunction (PBM).


METHODS
In 63 patients with a definite diagnosis of PBM, the ability to visualize the bile and main pancreatic ducts was compared between ERCP, which was performed in 63 patients with a definite diagnosis of PBM, and magnetic resonance cholangiopancreatography (MRCP), which was performed before ERCP in 29 patients. For ERCP, its complications were also evaluated.


RESULTS
The intrahepatic bile ducts could be visualized using ERCP in 44 patients (69.8%) and using MRCP in 18 (62.1%). The extrahepatic bile ducts could be visualized using ERCP in 59 patients (93.7%) and using MRCP in 29 (100%). The rates of the visualization of the main pancreatic duct and pancreaticobiliary ductal union were significantly higher in using ERCP than in using MRCP (96.8 vs. 41.4% and 90.5 vs. 37.9%, respectively; P<0.0001). As complications, hyperamylasemia developed in 12 patients (19%), but no other severe complications such as pancreatitis were observed.


CONCLUSIONS
ERCP as part of an in-depth preoperative examination of children with PBM is useful and safe.
Department of Gastroenterology and Hepatology Nagoya University Graduate School of Medicine, Nagoya, Japan.
Takeshi
T
Hiramatsu
Department of Gastroenterology and Hepatology Nagoya University Graduate School of Medicine, Nagoya, Japan.
Akihiro
A
Itoh
Department of Gastroenterology and Hepatology Nagoya University Graduate School of Medicine, Nagoya, Japan.
Hiroki
H
Kawashima
Department of Endoscopy, Nagoya University Hospital, Nagoya, Japan.
Eizaburo
E
Ohno
Department of Gastroenterology and Hepatology Nagoya University Graduate School of Medicine, Nagoya, Japan.
Yuya
Y
Itoh
Department of Gastroenterology and Hepatology Nagoya University Graduate School of Medicine, Nagoya, Japan.
Hiroyuki
H
Sugimoto
Department of Gastroenterology and Hepatology Nagoya University Graduate School of Medicine, Nagoya, Japan.
Hajime
H
Sumi
Department of Endoscopy, Nagoya University Hospital, Nagoya, Japan.
Kohei
K
Funasaka
Department of Gastroenterology and Hepatology Nagoya University Graduate School of Medicine, Nagoya, Japan.
Masanao
M
Nakamura
Department of Gastroenterology and Hepatology Nagoya University Graduate School of Medicine, Nagoya, Japan.
Ryoji
R
Miyahara
Department of Gastroenterology and Hepatology Nagoya University Graduate School of Medicine, Nagoya, Japan.
Yoshiaki
Y
Katano
Department of Gastroenterology and Hepatology Nagoya University Graduate School of Medicine, Nagoya, Japan.
Masatoshi
M
Ishigami
Department of Gastroenterology and Hepatology Nagoya University Graduate School of Medicine, Nagoya, Japan.
Naoki
N
Ohmiya
Department of Pediatric Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Kenitiro
K
Kaneko
Department of Pediatric Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Hisami
H
Ando
Department of Gastroenterology and Hepatology Nagoya University Graduate School of Medicine, Nagoya, Japan; Department of Endoscopy, Nagoya University Hospital, Nagoya, Japan.
Hidemi
H
Goto
Department of Endoscopy, Nagoya University Hospital, Nagoya, Japan. Electronic address: hirooka@med.nagoya-u.ac.jp.
Yoshiki
Y
Hirooka
D000293:Adolescent; D001649:Bile Duct Diseases / Q000151:congenital* / Q000175:diagnosis / Q000601:surgery; D001652:Bile Ducts / Q000002:abnormalities* / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000379:methods*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D010183:Pancreatic Ducts / Q000002:abnormalities* / Q000601:surgery; D012189:Retrospective Studies
Children; Endoscopic retrograde cholangiopancreatography; Magnetic resonance cholangiopancreatography; Pancreaticobiliary maljunction