Endoscopic Retrograde Cholangiopancreatography in Pediatric Patient Population: Bangladesh Perspective

Background : Endoscopic retrograde cholangiopancreatography (ERCP) is a  universally established modality in the evaluation and treatment of adults with  suspected biliary and pancreatic disease. Experience with ERCP in children has  been relatively limited especially in a developing country like Bangladesh. Objective: Aim of this study is to evaluate the diagnostic and therapeutic yields of ERCP  for biliary and pancreatic diseases in Bangladeshi children. Design and settings: This retrospective study was conducted in the departments of Gastroenterology &  Hepatology of Bangabandhu Memorial Hospital and Chattagram Metropolitan  Hospital, Chittagong, Bangladesh between 2004 and 2013. Patients: Seventy-three  patients (14 males and 59 females) aged 1 year 7 months to 18 years with the suspicion  of biliary or pancreatic diseases were included in this study. Interventions: Seventy-six procedures of ERCPs were performed. Main outcome measures: Common indications for ERCP and its therapeutic outcomes were assessed. Results: The most common indications were biliary ascariasis (25), choledocholithiasis  (17), biliary dilatation of unknown cause (11), chronic pancreatitis (3),  choledochal cyst (1), and Mirizzi syndrome (1). Therapeutic procedures included  sphincterotomy (41), worm extraction (25), stone extraction (12), and biliary  stenting (2). Adverse events were uncommon and usually minor. Conclusion: ERCP is a highly effective and safe diagnostic and therapeutic modality with  highest indication for biliary ascariasis in Bangladeshi children. DOI: http://dx.doi.org/10.11593/bje.2013.0103.0019 Bangladesh Journal of Endosurgery Vol.1(3) September 2013: 9-12