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内镜逆行胰胆管造影术用于诊断和治疗小儿胆胰疾病。

Endoscopic retrograde cholangiopancreatography for diagnosing and treating pediatric biliary and pancreatic diseases.

作者信息

Qin Xiu-Min, Yu Fei-Hong, Lv Chuan-Kai, Liu Zhi-Min, Wu Jie

机构信息

Department of Gastroenterology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China.

Department of Ultrasound, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China.

出版信息

World J Gastrointest Surg. 2023 Oct 27;15(10):2272-2279. doi: 10.4240/wjgs.v15.i10.2272.

Abstract

BACKGROUND

This study evaluated the safety and effectiveness of endoscopic retrograde cholangiopancreatography (ERCP) in pediatric patients with biliary and pancreatic diseases. A retrospective analysis was conducted on 57 ERCP procedures performed in 41 children, primarily for treating pancreatic diseases. The overall success rate was 91.2%, with no major complications observed. Post-ERCP pancreatitis (PEP) occurred in 8.8% of cases. Follow-up examinations over one year showed no recurrence of biliary or pancreatic diseases. Notably, endoscopic treatment led to a significant increase in body mass index (BMI). These findings demonstrate the valuable role of ERCP in managing such conditions.

AIM

To evaluate the safety and efficacy of ERCP for the management of biliary and pancreatic diseases in pediatric patients.

METHODS

We conducted a retrospective analysis of data from children aged 1-18 years who underwent ERCP for biliary and pancreatic diseases at Beijing Children's Hospital between January 2021 and December 2022. The collected data included procedure time, endoscopic treatment, success rate, and postoperative complications.

RESULTS

Forty-one children underwent 57 ERCP procedures, including 14 with biliary duct disease and 27 with pancreatic disease. The mean age of the patients was 7.48 ± 3.48 years. Biliary duct-related treatments were performed 18 times, and pancreatic disease treatments were performed 39 times. ERCP was primarily used to treat pediatric pancreatic diseases [68.4% (39/57) of the procedures]. The overall success rate was 91.2% (52/57 patients). PEP was noted in five patients (8.8%, 5/57), and no instances of bleeding, perforation, or cholangitis were observed. The patients were followed up for over one year, and no recurrence of biliary or pancreatic diseases was detected. Importantly, BMI significantly increased after endoscopic treatment compared to that before treatment ( = 0.001).

CONCLUSION

The high success rate and lack of major complications support the valuable role of ERCP in the management of pediatric biliary and pancreatic diseases in the pediatric population.

摘要

背景

本研究评估了内镜逆行胰胆管造影术(ERCP)在小儿胆胰疾病患者中的安全性和有效性。对41例儿童进行的57例ERCP手术进行了回顾性分析,主要用于治疗胰腺疾病。总体成功率为91.2%,未观察到重大并发症。8.8%的病例发生了ERCP术后胰腺炎(PEP)。一年的随访检查显示胆胰疾病无复发。值得注意的是,内镜治疗导致体重指数(BMI)显著增加。这些发现证明了ERCP在处理此类病症中的重要作用。

目的

评估ERCP治疗小儿胆胰疾病的安全性和有效性。

方法

我们对2021年1月至2022年12月在北京儿童医院接受ERCP治疗胆胰疾病的1至18岁儿童的数据进行了回顾性分析。收集的数据包括手术时间、内镜治疗、成功率和术后并发症。

结果

41例儿童接受了57例ERCP手术,其中14例患有胆管疾病,27例患有胰腺疾病。患者的平均年龄为7.48±3.48岁。胆管相关治疗进行了18次,胰腺疾病治疗进行了39次。ERCP主要用于治疗小儿胰腺疾病[68.4%(39/57)的手术]。总体成功率为91.2%(52/57例患者)。5例患者(8.8%,5/57)出现PEP,未观察到出血、穿孔或胆管炎病例。对患者进行了一年以上的随访,未发现胆胰疾病复发。重要的是,与治疗前相比,内镜治疗后BMI显著增加(P = 0.001)。

结论

高成功率和无重大并发症支持了ERCP在小儿胆胰疾病管理中的重要作用。

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