Zhang Tian, Shu Yijun, Weng Hao, Weng Mingzhe, Zhou Ying, Cai Wei, Wang Xuefeng
Department of Pediatric Surgery, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, 1665 KongJiang Street, Shanghai, 200092, China.
Department of General Surgery, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, 1665 Kongjiang Street, Shanghai, 200092, China.
BMC Pediatr. 2024 Apr 27;24(1):281. doi: 10.1186/s12887-024-04765-4.
Endoscopic retrograde cholangiopancreatography (ERCP) has found extensive use in pediatric patients; however, challenges persist in the application of therapeutic ERCP in infants.
This case report details the presentation of a 5.9-kilogram infant with obstructive jaundice and suspected hemolytic anemia who underwent ERCP to alleviate biliary obstruction. The infant was admitted due to clay-colored stools, jaundice, and liver injury. Ultrasound and magnetic resonance cholangiopancreatography (MRCP) revealed dilation of the common bile duct (CBD) accompanied by the presence of stones. ERCP was conducted using a JF-260V duodenoscope under general anesthesia. Successful stone extraction and biliary drainage were achieved.
In centers with considerable expertise in ERCP and pediatric anesthesia, the use of a conventional adult duodenoscope for therapeutic ERCP in infants can be considered safe and feasible, provided careful and stringent patient selection criteria are applied. In the future, clear guidelines and standardized protocols for the indications and procedures of pediatric ERCP should be established.
内镜逆行胰胆管造影术(ERCP)在儿科患者中已得到广泛应用;然而,治疗性ERCP在婴儿中的应用仍存在挑战。
本病例报告详细介绍了一名体重5.9千克、患有梗阻性黄疸和疑似溶血性贫血的婴儿,该婴儿接受了ERCP以缓解胆道梗阻。婴儿因陶土样大便、黄疸和肝损伤入院。超声和磁共振胰胆管造影(MRCP)显示胆总管(CBD)扩张并伴有结石。在全身麻醉下使用JF - 260V十二指肠镜进行ERCP。成功取出结石并实现胆道引流。
在具备ERCP和儿科麻醉专业知识的中心,若应用仔细且严格的患者选择标准,可考虑使用传统成人十二指肠镜对婴儿进行治疗性ERCP,这是安全可行的。未来,应制定关于儿科ERCP适应证和操作的明确指南及标准化方案。