Scientists in America have conducted a study to compare the success and complications of diagnostic and therapeutic ERCP in children under the age of 18 years with those found in adult patients.
Dr Shyam Varadarajulu and colleagues carried out their retrospective case-controlled study using all children undergoing ERCP at two centers between 1994 and 2002.
Prospective subjects were identified from endoscopy databases and were matched with adult patients for all variables apart from age. These included indication and procedure complexity.
Outcomes with regard to technical success and complications were then compared between the adult and the pediatric cohorts.
|Procedure success rate:|
Adults 98%Children 97.5%
Grade of procedure complexity and procedure-related complications were also defined, by using established criteria.
The researchers recruited a total of 116 children (mean age 9.3 years, range 1 month to 17 years; median age 8.1 years) and 116 matched adult patients (mean age 56.3 years, range 20-83 years; median age 49.7 years) to the study. These patients underwent 163 and 173 ERCP procedures, respectively.
According to procedure complexity grade, each group included the same number of patients, grade I, 72 patients; grade II, 12 patients; and grade III, 32 patients.
Procedure success rate was 97.5% in children vs. 98% in the adult cohort, while the complication rate was not significantly different between children and adult patients (3.4% vs. 2.5%).
The researchers found that most complications were of mild severity and encountered only in patients who underwent grade III procedures, with the exception of a single adult in whom moderate post-sphincterotomy bleeding developed after extraction of a large bile duct stone (grade II complexity).
Commenting on their findings, Dr Varadarajulu said, " When ERCP is performed in children by expert endoscopists, the success rate is high and the complication rate is low, both being comparable with those for ERCP in adult patients."