Skip to main content
Top
Published in: BMC Pediatrics 1/2024

Open Access 27-04-2024 | Endoscopic Retrograde Cholangiopancreatography | Case Report

A therapeutic ERCP in an only 5.9 kg infant with obstruction jaundice using JF-260V duodenoscope

Authors: Tian Zhang, Yijun Shu, Hao Weng, Mingzhe Weng, Ying Zhou, Wei Cai, Xuefeng Wang

Published in: BMC Pediatrics | Issue 1/2024

Login to get access

Abstract

Background

Endoscopic retrograde cholangiopancreatography (ERCP) has found extensive use in pediatric patients; however, challenges persist in the application of therapeutic ERCP in infants.

Case presentation

This case report details the presentation of a 5.9-kilogram infant with obstructive jaundice and suspected hemolytic anemia who underwent ERCP to alleviate biliary obstruction. The infant was admitted due to clay-colored stools, jaundice, and liver injury. Ultrasound and magnetic resonance cholangiopancreatography (MRCP) revealed dilation of the common bile duct (CBD) accompanied by the presence of stones. ERCP was conducted using a JF-260V duodenoscope under general anesthesia. Successful stone extraction and biliary drainage were achieved.

Conclusions

In centers with considerable expertise in ERCP and pediatric anesthesia, the use of a conventional adult duodenoscope for therapeutic ERCP in infants can be considered safe and feasible, provided careful and stringent patient selection criteria are applied. In the future, clear guidelines and standardized protocols for the indications and procedures of pediatric ERCP should be established.
Literature
1.
go back to reference Arvanitakis M, Devière J. Endoscopic retrograde cholangiopancreatography (ERCP). Endoscopy. 2009;41:890–4.CrossRefPubMed Arvanitakis M, Devière J. Endoscopic retrograde cholangiopancreatography (ERCP). Endoscopy. 2009;41:890–4.CrossRefPubMed
2.
go back to reference Barakat MT, Berquist WE, Gugig R. Cholangioscopy in children and adolescents: utilization, outcomes, and safety. J Pediatr Gastroenterol Nutr. 2022;75:196–201.CrossRefPubMed Barakat MT, Berquist WE, Gugig R. Cholangioscopy in children and adolescents: utilization, outcomes, and safety. J Pediatr Gastroenterol Nutr. 2022;75:196–201.CrossRefPubMed
3.
go back to reference Buckley A, Connon JJ. The role of ERCP in children and adolescents. Gastrointest Endosc. 1990;36:369–72.CrossRefPubMed Buckley A, Connon JJ. The role of ERCP in children and adolescents. Gastrointest Endosc. 1990;36:369–72.CrossRefPubMed
4.
go back to reference Varadarajulu S, Wilcox CM, Hawes RH, Cotton PB. Technical outcomes and complications of ERCP in children. Gastrointest Endosc. 2004;60:367–71.CrossRefPubMed Varadarajulu S, Wilcox CM, Hawes RH, Cotton PB. Technical outcomes and complications of ERCP in children. Gastrointest Endosc. 2004;60:367–71.CrossRefPubMed
5.
go back to reference Aabakken L, Aagenaes I, Sanengen T, Aasen S, Emblem R, Bjornland K. Utility of ERCP in neonatal and infant cholestasis. J Laparoendosc Adv Surg Tech A. 2009;19:431–6.CrossRefPubMed Aabakken L, Aagenaes I, Sanengen T, Aasen S, Emblem R, Bjornland K. Utility of ERCP in neonatal and infant cholestasis. J Laparoendosc Adv Surg Tech A. 2009;19:431–6.CrossRefPubMed
6.
go back to reference Felux J, Sturm E, Busch A, Zerabruck E, Graepler F, Stüker D, et al. ERCP in infants, children and adolescents is feasible and safe: results from a tertiary care center. United Eur Gastroenterol J. 2017;5:1024–9.CrossRef Felux J, Sturm E, Busch A, Zerabruck E, Graepler F, Stüker D, et al. ERCP in infants, children and adolescents is feasible and safe: results from a tertiary care center. United Eur Gastroenterol J. 2017;5:1024–9.CrossRef
7.
go back to reference Hiramatsu T, Itoh A, Kawashima H, Ohno E, Itoh Y, Sugimoto H, et al. Usefulness and safety of endoscopic retrograde cholangiopancreatography in children with pancreaticobiliary maljunction. J Pediatr Surg. 2015;50:377–81.CrossRefPubMed Hiramatsu T, Itoh A, Kawashima H, Ohno E, Itoh Y, Sugimoto H, et al. Usefulness and safety of endoscopic retrograde cholangiopancreatography in children with pancreaticobiliary maljunction. J Pediatr Surg. 2015;50:377–81.CrossRefPubMed
8.
go back to reference Wang Q, Moon SB, Zang J, Liu J, Weng H, Wang X, et al. Usefulness of pre-operative endoscopic retrograde cholangiopancreatography in diagnosis and management of forme fruste choledochal cyst in children. ANZ J Surg. 2020;90:1041–5.CrossRefPubMed Wang Q, Moon SB, Zang J, Liu J, Weng H, Wang X, et al. Usefulness of pre-operative endoscopic retrograde cholangiopancreatography in diagnosis and management of forme fruste choledochal cyst in children. ANZ J Surg. 2020;90:1041–5.CrossRefPubMed
9.
go back to reference Kopljar M, Ivandić S, Mesić M, Bakota B, Žiger T, Kondža G, et al. Operative versus non-operative management of blunt pancreatic trauma in children: systematic review and meta-analysis. Injury. 2021;52(Suppl 5):S49–s57.CrossRefPubMed Kopljar M, Ivandić S, Mesić M, Bakota B, Žiger T, Kondža G, et al. Operative versus non-operative management of blunt pancreatic trauma in children: systematic review and meta-analysis. Injury. 2021;52(Suppl 5):S49–s57.CrossRefPubMed
10.
11.
go back to reference Deng Z, Zeng J, Lv C, Jiang L, Ji J, Li X, et al. Prevalence and factors associated with post-endoscopic retrograde cholangiopancreatography pancreatitis in children. Dig Dis Sci. 2021;66:224–30.CrossRefPubMed Deng Z, Zeng J, Lv C, Jiang L, Ji J, Li X, et al. Prevalence and factors associated with post-endoscopic retrograde cholangiopancreatography pancreatitis in children. Dig Dis Sci. 2021;66:224–30.CrossRefPubMed
12.
go back to reference Lou Q, Sun J, Zhang X, Shen H. Successful therapeutic ERCP in a 99-day-old child with common bile duct stones: a case report and discussions on the particularities of the ERCP in children. Front Pediatr. 2020;8:435.CrossRefPubMedPubMedCentral Lou Q, Sun J, Zhang X, Shen H. Successful therapeutic ERCP in a 99-day-old child with common bile duct stones: a case report and discussions on the particularities of the ERCP in children. Front Pediatr. 2020;8:435.CrossRefPubMedPubMedCentral
13.
go back to reference Yıldırım AE, Altun R, Ocal S, Kormaz M, Ozcay F, Selcuk H. The safety and efficacy of ERCP in the pediatric population with standard scopes: does size really matter? Springerplus. 2016;5:128.CrossRefPubMedPubMedCentral Yıldırım AE, Altun R, Ocal S, Kormaz M, Ozcay F, Selcuk H. The safety and efficacy of ERCP in the pediatric population with standard scopes: does size really matter? Springerplus. 2016;5:128.CrossRefPubMedPubMedCentral
14.
go back to reference Durakbasa CU, Balik E, Yamaner S, Bulut T, Büyükuncu Y, Sökücü N, et al. Diagnostic and therapeutic endoscopic retrograde cholangiopancreatography (ERCP) in children and adolescents: experience in a single institution. Eur J Pediatr Surg. 2008;18:241–4.CrossRefPubMed Durakbasa CU, Balik E, Yamaner S, Bulut T, Büyükuncu Y, Sökücü N, et al. Diagnostic and therapeutic endoscopic retrograde cholangiopancreatography (ERCP) in children and adolescents: experience in a single institution. Eur J Pediatr Surg. 2008;18:241–4.CrossRefPubMed
15.
go back to reference Issa H, Al-Haddad A, Al-Salem AH. Diagnostic and therapeutic ERCP in the pediatric age group. Pediatr Surg Int. 2007;23:111–6.CrossRefPubMed Issa H, Al-Haddad A, Al-Salem AH. Diagnostic and therapeutic ERCP in the pediatric age group. Pediatr Surg Int. 2007;23:111–6.CrossRefPubMed
16.
go back to reference Barth BA, Banerjee S, Bhat YM, Desilets DJ, Gottlieb KT, Maple JT, et al. Equipment for pediatric endoscopy. Gastrointest Endosc. 2012;76:8–17.CrossRefPubMed Barth BA, Banerjee S, Bhat YM, Desilets DJ, Gottlieb KT, Maple JT, et al. Equipment for pediatric endoscopy. Gastrointest Endosc. 2012;76:8–17.CrossRefPubMed
17.
go back to reference Sun R, Xu X, Zheng Q, Zhan J. Therapeutic endoscopic retrograde cholangiopancreatography for pediatric hepato-pancreato-biliary diseases: a systematic review and meta-analysis. Front Pediatr. 2022;10:915085.CrossRefPubMedPubMedCentral Sun R, Xu X, Zheng Q, Zhan J. Therapeutic endoscopic retrograde cholangiopancreatography for pediatric hepato-pancreato-biliary diseases: a systematic review and meta-analysis. Front Pediatr. 2022;10:915085.CrossRefPubMedPubMedCentral
18.
go back to reference Keil R, Drábek J, Lochmannová J, Šťovíček J, Koptová P, Wasserbauer M, et al. ERCP in infants, children, and adolescents-Different roles of the methods in different age groups. PLoS One. 2019;14:e0210805.CrossRefPubMedPubMedCentral Keil R, Drábek J, Lochmannová J, Šťovíček J, Koptová P, Wasserbauer M, et al. ERCP in infants, children, and adolescents-Different roles of the methods in different age groups. PLoS One. 2019;14:e0210805.CrossRefPubMedPubMedCentral
19.
go back to reference Guelrud M, Jaen D, Mendoza S, Plaz J, Torres P. ERCP in the diagnosis of extrahepatic biliary atresia. Gastrointest Endosc. 1991;37:522–6.CrossRefPubMed Guelrud M, Jaen D, Mendoza S, Plaz J, Torres P. ERCP in the diagnosis of extrahepatic biliary atresia. Gastrointest Endosc. 1991;37:522–6.CrossRefPubMed
20.
go back to reference Sanada Y, Yamaguchi M, Chiba M, Nemoto H, Yoshizawa Y, Hirota Y, et al. Endoscopic sphincterotomy and laparoscopic cholecystectomy in an infant with cholecysto-choledocholithiasis. J Pediatr Surg. 1998;33:1312–4.CrossRefPubMed Sanada Y, Yamaguchi M, Chiba M, Nemoto H, Yoshizawa Y, Hirota Y, et al. Endoscopic sphincterotomy and laparoscopic cholecystectomy in an infant with cholecysto-choledocholithiasis. J Pediatr Surg. 1998;33:1312–4.CrossRefPubMed
21.
go back to reference Teng R, Yokohata K, Utsunomiya N, Takahata S, Nabae T, Tanaka M. Endoscopic retrograde cholangiopancreatography in infants and children. J Gastroenterol. 2000;35:39–42.CrossRefPubMed Teng R, Yokohata K, Utsunomiya N, Takahata S, Nabae T, Tanaka M. Endoscopic retrograde cholangiopancreatography in infants and children. J Gastroenterol. 2000;35:39–42.CrossRefPubMed
22.
go back to reference Weng M, Wang L, Weng H, Gu J, Wang X. Utility of endoscopic retrograde cholangiopancreatography in infant patients with conservational endoscopy. Transl Pediatr. 2021;10:2506–13.CrossRefPubMedPubMedCentral Weng M, Wang L, Weng H, Gu J, Wang X. Utility of endoscopic retrograde cholangiopancreatography in infant patients with conservational endoscopy. Transl Pediatr. 2021;10:2506–13.CrossRefPubMedPubMedCentral
23.
go back to reference Usatin D, Fernandes M, Allen IE, Perito ER, Ostroff J, Heyman MB. Complications of endoscopic retrograde cholangiopancreatography in pediatric patients; a systematic literature review and meta-analysis. J Pediatr. 2016;179:160–5.e3.CrossRefPubMedPubMedCentral Usatin D, Fernandes M, Allen IE, Perito ER, Ostroff J, Heyman MB. Complications of endoscopic retrograde cholangiopancreatography in pediatric patients; a systematic literature review and meta-analysis. J Pediatr. 2016;179:160–5.e3.CrossRefPubMedPubMedCentral
24.
go back to reference Zhang J, Ye L, Zhang J, Lin M, He S, Mao X, et al. MELD scores and Child-Pugh classifications predict the outcomes of ERCP in cirrhotic patients with choledocholithiasis: a retrospective cohort study. Medicine (Baltimore). 2015;94:e433.CrossRefPubMed Zhang J, Ye L, Zhang J, Lin M, He S, Mao X, et al. MELD scores and Child-Pugh classifications predict the outcomes of ERCP in cirrhotic patients with choledocholithiasis: a retrospective cohort study. Medicine (Baltimore). 2015;94:e433.CrossRefPubMed
25.
go back to reference Hassan AM, Lin TK, Smith MT, Hornung L, Abu-El-Haija M, Nathan JD, et al. Risk Factors for Post-ERCP Pancreatitis in Pediatric and Young Adult Patients. J Pediatr Gastroenterol Nutr. 2023;76:807–12.CrossRefPubMed Hassan AM, Lin TK, Smith MT, Hornung L, Abu-El-Haija M, Nathan JD, et al. Risk Factors for Post-ERCP Pancreatitis in Pediatric and Young Adult Patients. J Pediatr Gastroenterol Nutr. 2023;76:807–12.CrossRefPubMed
Metadata
Title
A therapeutic ERCP in an only 5.9 kg infant with obstruction jaundice using JF-260V duodenoscope
Authors
Tian Zhang
Yijun Shu
Hao Weng
Mingzhe Weng
Ying Zhou
Wei Cai
Xuefeng Wang
Publication date
27-04-2024

Other articles of this Issue 1/2024

BMC Pediatrics 1/2024 Go to the issue