Safety of endoscopic retrograde cholangiopancreatography in the pediatric population: a multicenter study
| Autor: | Stéphane Koch, Nicolas Williet, Clémence Mercier, Pierre Henri Deprez, Marion Schaefer, Isabelle Scheers, Jean-Phillippe Le Mouel, Frédéric Prat, Marc Barthet, Aline Derosiere, Jean-Baptiste Chevaux, Julien Branche, Jean-Christophe Valats, Phillipe Grandval, Thierry Ponchon, Isabelle Boytchev, Geoffroy Vanbiervliet, Caroline Chabot, Clement Fortier Beaulieu, Nicolas Musquer, Emmanuel Coron, Mathieu Pioche, Timothée Wallenhorst, Franz Rudler, Aurélie Comte, Jean-Michel Gonzalez, Arthur Belle, Eliane Albuisson |
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| Přispěvatelé: | Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Application des ultrasons à la thérapie (LabTAU), Centre Léon Bérard [Lyon]-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale (INSERM), Hôpital Edouard Herriot [CHU - HCL], Hospices Civils de Lyon (HCL), Service d'hépatologie et de gastroentérologie [Hôpital Saint-Joseph - Marseille], Aix Marseille Université (AMU)-Hôpital Saint-Joseph [Marseille], Service d'Hépato-gastro-entérologie [APHP Kremlin-Bicêtre], AP-HP Hôpital Bicêtre (Le Kremlin-Bicêtre), Centre Hospitalier Universitaire de Nice (CHU Nice), Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service de Gastro-entérologie [CHU Cochin], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Cochin [AP-HP], Hôpital Claude Huriez [Lille], CHU Lille, Centre de Recherche en Cancérologie de Marseille (CRCM), Aix Marseille Université (AMU)-Institut Paoli-Calmettes, Fédération nationale des Centres de lutte contre le Cancer (FNCLCC)-Fédération nationale des Centres de lutte contre le Cancer (FNCLCC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Université de Montpellier (UM), Hôpital Sud [CHU Rennes], CHU Pontchaillou [Rennes], Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Service de chirurgie pédiatrique [CHU Besançon], Centre Hospitalier Universitaire de Saint-Etienne [CHU Saint-Etienne] (CHU ST-E), Centre hospitalier universitaire de Nantes (CHU Nantes), Service d'Hépato Gastroenterologie [CHU Amiens-Picardie], CHU Amiens-Picardie, Cliniques Universitaires Saint-Luc [Bruxelles] |
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
medicine.medical_treatment Perforation (oil well) Liver transplantation MESH: Catheterization Catheterization MESH: Child medicine Humans Neonatal cholestasis Child Retrospective Studies Cholangiopancreatography Endoscopic Retrograde Univariate analysis MESH: Humans Endoscopic retrograde cholangiopancreatography medicine.diagnostic_test business.industry MESH: Infant Newborn Gastroenterology Infant Newborn MESH: Retrospective Studies [SDV.MHEP.HEG]Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology Odds ratio medicine.disease Surgery MESH: Pancreatitis Choledocholithiasis Pancreatitis MESH: Cholangiopancreatography Endoscopic Retrograde MESH: Choledocholithiasis business Complication |
| Zdroj: | Endoscopy Endoscopy, 2021, 53 (06), pp.586-594. ⟨10.1055/a-1209-0155⟩ |
| ISSN: | 1438-8812 0013-726X |
| Popis: | Introduction The aims of this retrospective multicenter study were to assess the technical success and adverse events of endoscopic retrograde cholangiopancreatography (ERCP) procedures in children in French and Belgian centers. Methods All children aged 1 day to 17 years who underwent ERCP between January 2008 and March 2019 in 15 tertiary care hospitals were retrospectively included. Results 271 children underwent 470 ERCP procedures. Clinical long-term follow-up was available for 72 % of our patients (340/470 procedures). The median age at intervention was 10.9 years. ERCP was therapeutic in 90 % (423/470) and diagnostic in cases of neonatal cholestasis in 10 % of the patients. The most common biliary indication was choledocholithiasis; the most common pancreatic indication was chronic pancreatitis. Biliary cannulation was successful in 92 % of cases (270/294); pancreatic cannulation in 96 % of cases (169/176); and planned therapeutic procedures in 92 % of cases (388/423). The overall complication rate was 19 % (65/340). The most common complication was post-ERCP pancreatitis (PEP) in 12 % of cases (40/340) and sepsis in 5 % (18/340). On univariate analyses, pancreatic stent removal was protective against PEP (odds ratio [OR] 0.1, 95 % confidence interval [CI] 0.01 – 0.75; P = 0.03), and sepsis was associated with history of liver transplantation (OR 7.27, 95 %CI 1.7 – 31.05; P = 0.01). Five patients had post-ERCP hemorrhage and two had intestinal perforation. All complications were managed with supportive medical care. There was no procedure-related mortality. Conclusion Our cohort demonstrates that ERCP can be performed safely with high success rates in many pancreaticobiliary diseases of children. The rate of adverse events was similar to that in previous reports. |
| Databáze: | OpenAIRE |
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