ERCP-Related adverse events in pediatric patients: a 10-years single-site review
link.springer.com shows its articles on its own site.
Read the article on link.springer.com ↗Article · Jul 2024 · 1 min read
In brief
In brief
A 10-year retrospective study of 113 ERCP procedures in 76 pediatric patients demonstrates the procedure's safety and feasibility in children over 3 years old, with post-ERCP pancreatitis (14.2%) and abdominal pain (17.7%) being the most common adverse events. No severe complications like bleeding or perforation occurred, though patients requiring repeat ERCP showed higher initial adverse event rates (57.7%).
- ERCP achieved 100% technical success in 76 pediatric patients (ages 3-17) with no bleeding, perforation, or cholangitis over 10 years.
- Post-ERCP pancreatitis occurred in 14.2% of procedures, making it the most common serious adverse event in pediatric ERCP.
- Post-ERCP abdominal pain affected 17.7% of cases, representing the most frequent overall complication in this pediatric cohort.
- Children requiring repeat ERCP had 57.7% adverse event rate at initial procedure, significantly higher than the 14.2% overall average.
- ERCP is safe and feasible in children over 3 years old when performed at experienced centers with active post-procedure monitoring.
Written by the GCMD Library team from the article.
Abstract
Purpose
This retrospective analysis aimed to assess the feasibility and safety of endoscopic retrograde cholangiopancreatography (ERCP) in pediatric patients by examining ERCP-related adverse events (AEs) occurring over a decade at a single center.
Methods
Pediatric patients under 18 years old who underwent ERCP at the Second Hospital of Hebei Medical University from 1/2013 to 11/2023 were included. ERCP-related AEs were defined according to ERCP-related adverse events: European Society of Gastrointestinal Endoscopy (ESGE) Guideline. Clinical data of patients experiencing ERCP-related AEs were obtained from electronic medical records for analysis.
Results
Over the past decade, a total of 76 pediatric patients underwent 113 ERCP procedures, including 26 patients who underwent repeat ERCP, totaling 63 procedures. There were 32 males and 44 females, with a median age of 13 years (range 3 years and 5 months–17 years and 9 months). Among all ERCP procedures, 14 (12.4%) were diagnostic and 99 (87.6%) were therapeutic, with a 100% success rate. 16 cases (14.2%) of ERCP-related AEs, all post-ERCP pancreatitis (PEP), were observed, while no other AEs defined by ESGE such as bleeding, perforation, cholangitis, cholecystitis, or sedation-related events were noted. Additionally, 23 cases (20.4%) of ERCP-related AEs not included in the ESGE definition were observed, including post-ERCP abdominal pain in 20 cases (17.7%), post-ERCP nausea and vomiting in 2 cases (1.8%), and unplanned reoperation in 1 case (0.9%). In the 26 cases of pediatric patients who underwent repeat ERCP, we observed that AEs occurred in 15 cases (57.7%) during their initial ERCP, which was much higher than the overall average level.
Conclusions
Post-ERCP abdominal pain and PEP are the most common ERCP-related AEs in pediatric patients, while severe AEs such as bleeding and perforation are rare. The incidence of AEs after initial ERCP in pediatric patients who received repeat ERCP is higher than the overall average level. Based on our center's experience, we believe that ERCP can be safely performed in children over 3 years old with biliary and pancreatic diseases and obtain reliable clinical benefits. However, active monitoring and management of ERCP-related AEs are essential to improve the clinical outcomes of pediatric ERCP.