The usefulness of endoscopic retrograde cholangiopancreatography in infants and small children.

We performed endoscopic retrograde cholangiopancreatography (ERCP) on nine infants and small children over a period of 7 yr from 1985 to 1991. In three infants, diagnosis on admission was congenital biliary atresia or neonatal hepatitis. In one, congenital biliary atresia was diagnosed by ERCP. In the other six cases, diagnosis on admission was congenital biliary dilation, acute cholangitis, or acute pancreatitis. In five, we diagnosed the anomalous arrangement of the pancreaticobiliary ductal system by ERCP. ERCP is a relatively easy and safe technique when applied to infants and small children. It is also a useful procedure when making morphologic diagnosis of organic disorders around the biliary and pancreatic ductal system, such as biliary atresia, intrahepatic cholestasis, and the anomalous arrangement of the pancreaticobiliary ductal system. It enables us to determine the surgical procedure and to investigate the residual bile duct after surgical treatment. Therefore, ERCP should be conducted on infants and small children who may be suffering from disorders of the pancreaticobiliary system.