Complications of endoscopic retrograde cholangiopancreatography ( ERCP ) in children with pancreatitis

Objective To study the complications of endoscopic retrograde cholangiopancreato-graphy (ERCP) in children with pancreatitis. Methods 27 children with pancreatitis who had been treated with ERCP in Changhai Hospital from Feb 1997 to Feb 2002 were analyzed retrospectively. They included 9 boys and 18 girls ranging in age from 4 to 17 years (14. 81±2. 87). Of the 27 cases of pancreatitis, 14 were acute pancreatitis(AP) and 13 were chronic pancreatitis(CP). ERCP was simply diagnostic in 9 patients and therapeutic in 18. All ERCP procedures were performed by experienced endoscopists. Results The overall success rate was 100%. The overall ERCP related morbidity was 57. 98% (14/27), including hyperamylasemia in 6 cases (22. 22%), pancreatitis in 6 cases (22. 2%), and hemorrhage from papillosphincterotomy in 2 cases (7. 41%). The serum amylase levels in the hyperamylasemia cases were (410. 75 ± 230. 31) U/L and (367. 25± 233. 90) U/L at 4h and 24h after ERCP respectively. The incidence of hyperamylasemia, abdominal pain, pancreatitis was higher in the therapeutic group than in the diagnostic group, though there was no statistically significant difference (P0. 05). Conclusions ERCP had a much higher complication rate in children than in adults, mostly associated with therapeutic procedures, and therefore more precautions should be given to pediatric patients in doing ERCP to decrease the potential adverse events.