Dalal Ankit, Kamat Nagesh, Patil Gaurav, Daftary Rajen, Maydeo Amit
Baldota Institute of Digestive Sciences, Gleneagles Global Hospital, Mumbai, Maharashtra, India.
Endosc Int Open. 2022 Feb 15;10(2):E192-E199. doi: 10.1055/a-1675-2291. eCollection 2022 Feb.
Endoscopic ultrasound (EUS) is useful in diagnosing and treating childhood pancreatobiliary and gastrointestinal diseases. However, there are limited data on its effectiveness for various indications. This was a retrospective analysis of prospectively collected data of patients who underwent EUS for upper gastrointestinal tract disorders from January 2018 to December 2020 to assess its indications, findings, interventions, and complications. Ninety-two procedures were performed in 85 children, (70.5 % male; mean [SD] age 12.1 years [3.9] years) with a mean (SD) symptom duration of 1.1 (0.5) years. The procedures were technically successful in all patients. The primary indication for EUS was abdominal pain in 45(52.9%) and jaundice/cholangitis in 15 patients (17.6 %). General anesthesia was used in 12 (13 %) and TIVA in 80 patients (87 %). The most common diagnostic findings were choledocholithiasis in 21 (24.7 %) and cholelithiasis in 12 patients (14.1 %). Among interventions, EUS-guided cystogastrostomy for pancreatic pseudocyst was done in four patients (4.7 %), and EUS-guided rendezvous for failed ERCP in one patient (1.2 %) with cholangitis. There were no immediate post-procedural complications. Overall, EUS had a meaningful impact on the subsequent clinical management in 69 cases (81.2 %). EUS in the pediatric population is safe, effective, and has a meaningful impact in appropriately selected cases. It can act as a rescue in major therapeutic procedures, but adequate care should be taken at the procedural level and during anesthesia.
内镜超声（EUS）在诊断和治疗儿童胰腺胆管及胃肠道疾病方面很有用。然而，关于其对各种适应症有效性的数据有限。这是一项对2018年1月至2020年12月因上消化道疾病接受EUS检查的患者前瞻性收集数据的回顾性分析，以评估其适应症、检查结果、干预措施和并发症。85名儿童接受了92例EUS检查（男性占70.5%；平均[标准差]年龄12.1岁[3.9岁]），平均（标准差）症状持续时间为1.1（0.5）年。所有患者的检查在技术上均获成功。EUS的主要适应症为腹痛45例（52.9%），黄疸/胆管炎15例（17.6%）。12例（13%）使用全身麻醉，80例（87%）使用全凭静脉麻醉。最常见的诊断结果为胆总管结石21例（24.7%），胆结石12例（14.1%）。在干预措施方面，4例（4.7%）患者接受了EUS引导下的胰腺假性囊肿胃造瘘术，1例（1.2%）胆管炎患者因内镜逆行胰胆管造影（ERCP）失败接受了EUS引导下会师术。术后无即刻并发症。总体而言，EUS对69例（81.2%）患者的后续临床管理产生了有意义的影响。儿科人群中的EUS是安全、有效的，并且在适当选择的病例中具有有意义的影响。它可在主要治疗程序中起到补救作用，但在操作层面和麻醉期间应给予充分的护理。
