Experience in the endoscopic treatment of biliary lithiasis in children
Keywords:
cholecystectomy; choledocholithiasis; endoscopic retrograde cholangiopancreatography; ERCP; pediatrics; sphincterotomyAbstract
Introduction: Endoscopic retrograde cholangiopancreatography (ERCP) is a useful endoscopic procedure in the treatment of biliary tract stones.
Objective: To describe the level of competence and performance achieved in the endoscopic treatment of biliary stones in children.
Methods: The outcomes were evaluated in a series of 45 pediatric patients with biliary stones who underwent ERCP and laparoscopic cholecystectomy. The competence and performance of the specialists were assessed based on the results in the series and on international standards. Age, sex, reasons for the ERCP indication, type of ERCP, diagnoses made, and procedures performed during the ERCPs were studied.
Results: The mean age was 15 years (range 4–18 years); 33 (73%) were female and 12 (27%) were male. Thirty-four patients (76%) were diagnosed with obstructive jaundice, nine (20%) with symptomatic gallstones underwent laparoscopic cholecystectomy, and two (4%) presented with biliary pancreatitis. Forty-two therapeutic ERCPs (93%) were performed; biliary sphincterotomy and stone extraction were performed in 33 patients (79%). The cannulation rate, gallstone extraction rate, and obstructed duct drainage rate were all 100%. Complications occurred in two patients (4.4%), both minor post-sphincterotomy hemorrhages. There were no deaths. The level of performance was adequate.
Conclusions: The team demonstrated an adequate level of competence and performance in the endoscopic treatment of gallstones in children.
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