Endoscopic Retrograde Cholangiopancreatograpy (ERCP) in the Evaluation and Management of Abdominal Pain in Children: Experience From a Tertiary Care Center

Endoscopic Retrograde Cholangiopancreatograpy (ERCP) in the Evaluation and Management of Abdominal Pain in Children: Experience From a Tertiary Care Center Raj Santharam, Adrian Miranda, Steven Werlin, Kulwinder Dua Introduction: Previous studies have shown ERCP to be feasible and safe in the pediatric population. Aim: To determine the utility of ERCP in the diagnosis and management of abdominal pain in children. Methods: Children (%18 years) undergoing ERCP for evaluation of abdominal pain at one tertiary care center (1996-2003) were identified using an endoscopy database and retrospectively studied. Abdominal pain suggestive of pancreatobiliary origin was classified as Type I if associated with abnormal liver tests and/or abnormal pancreatic enzymes. Those with abdominal pain alone were classified as Type II. Datasets with regard to technical success, outcomes and complications were evaluated. Results: A total of 146 children, (age n: !1 yr, 7; 1 to 12 yrs, 79; 13 to 18yrs, 60) underwent 185 ERCP’s. There were 97 children with type I pain and 49 patients with type II pain. Technical success, as defined by successful papillary cannulation with therapeutic interventions where required, was achieved in 182 of 185 ERCP’s (98%). The diagnostic and therapeutic utility of ERCP in the individual categories of pain is shown in the Table 1. Post-ERCP complications were encountered in 2.1% of patients, none of which required hospitalization beyond one week. There were no procedure related mortalities. Conclusions: ERCP in children is safe and can be performed with high success rates. In addition to the high utility of ERCP in the diagnosis and management of abdominal pain in children with abnormal liver and/ or pancreatic tests, ERCP was also found helpful in over 50% of those with abdominal pain alone.