Taj Muhammed Ali, Leghari Aftab, Qureshi Sajida, Ghazanfar Shahriyar, Niaz Saad Khalid, Quraishy Muhammed Saeed
Department of Medicine, Indus Hospital, Karachi.
J Pak Med Assoc. 2012 Feb;62(2):98-101.
To evaluate the indications, clinical features, complications, and effect on patient management of Endoscopic retrograde cholangiopancreatography (ERCP) in paediatric patients of varying age.
A prospective, descriptive cross sectional study was conducted at the endoscopy suite, Surgical Unit 4, Civil Hospital Karachi; from January 2007 to August 2010. All ERCPs performed during a 3-year period in patients aged 18 years or less were prospectively analyzed. Success was defined as having authentic diagnostic information or a successful endoscopic therapy.
A total of 40 children and adolescents (18 Males, 22 Females; mean age 13.6 +/- 3.37 years, range 3 to 18 years) underwent 52 ERCP procedures. Indications were biliary pathology in 21, and pancreatic pathology in 19. The ERCP findings were choledocholithiasis in 12 patients, choledochal cysts in 5, chronic pancreatitis in 8, pancreatic pseudocyst in 5, recurrent pancreatitis in 5, biliary ascariasis in 2, pancreatic divisum in 1, postoperative bile leak in 1, and benign biliary stricture in 1. ERCP was successful in 51 of 52 procedures. Single procedure was performed in 36 patients, where as two patients required 2 procedures and it was repeated 4 and 6 times in the remaining two patients. Endoscopic therapy was performed in 92% of the procedures. The complication rate was 1.9% (1/52 procedures) which included mild pancreatitis, whereas asymptomatic hyperamylasaemia was seen in 11% (6/52 procedures). No mortality related to ERCP occurred. ERCP affected management in 94% (49/52 patients).
ERCP is an effectual and safe therapeutic procedure in children and adolescents of different ages with a variety of pancreatobiliary disorders.
评估不同年龄段儿科患者内镜逆行胰胆管造影术（ERCP）的适应证、临床特征、并发症及对患者治疗的影响。
2007年1月至2010年8月在卡拉奇市民医院外科四病房内镜室进行了一项前瞻性描述性横断面研究。对18岁及以下患者在3年期间进行的所有ERCP进行前瞻性分析。成功定义为获得可靠的诊断信息或成功的内镜治疗。
共有40名儿童和青少年（18名男性，22名女性；平均年龄13.6±3.37岁，范围3至18岁）接受了52次ERCP操作。适应证为胆道疾病21例，胰腺疾病19例。ERCP检查结果为胆总管结石12例，胆总管囊肿5例，慢性胰腺炎8例，胰腺假性囊肿5例，复发性胰腺炎5例，胆道蛔虫病2例，胰腺分裂1例，术后胆漏1例，良性胆管狭窄1例。52例操作中有51例成功。36例患者进行了单次操作，2例患者需要2次操作，其余2例患者分别重复了4次和6次。92%的操作进行了内镜治疗。并发症发生率为1.9%（1/52例操作），包括轻度胰腺炎，而11%（6/52例操作）出现无症状高淀粉酶血症。未发生与ERCP相关的死亡。ERCP影响了94%（49/52例患者）的治疗。
ERCP是一种有效且安全的治疗方法，适用于不同年龄段患有各种胰胆疾病的儿童和青少年。
