Introduction: The aims of this retrospective multicentre study were to assess the technical success and adverse events of ERCP procedures in children in French and Belgian centres. Methods: All children aged one day to seventeen years who underwent ERCP between January 2008 and March 2019 in 15 tertiary care hospitals were retrospectively included. Results: 271 children underwent 470 ERCP procedures. Clinical long-term follow-up was available for 72% of our patients (340/470). The median age at intervention was 10.9 years. ERCP was therapeutic in 90% (423/470) and diagnostic in cases of neonatal cholestasis in 10% of the patients. The most common biliary indication was choledocholithiasis, and the most common pancreatic indication was chronic pancreatitis. Biliary cannulation was successful in 92% of cases (270/294); pancreatic cannulation, in 96% (169/176) of cases; and planned therapeutic procedures, in 91% (388/423) of cases. The overall complication rate was 19% (65/340). The most common complication was post-ERCP pancreatitis (PEP) in 12% (40/340) and sepsis in 5% (18/340) of cases. In the univariate analyses, pancreatic stent removal was protective against PEP (OR 0.1; 95% CI: 0.01-0.75, p=0.03), and sepsis was associated with liver transplantation history (OR 7.27, 95% CI: 1.7-31.05, p=0.01). Five patients had post-ERCP haemorrhage, and two had intestinal perforation. All complications were managed with supportive medical care. There was no procedure-related mortality. Conclusion: Our cohort demonstrates that ERCP can be performed safely with high success rates in many pancreaticobiliary diseases of children. The rate of adverse events was similar to that in previous reports.

Objectives The objective of this study was to assess the tolerance and efficacy of endoscopic intrapyloric botulinum toxin injection compared with pyloric dilatation in children with gastroparesis.Methods This was a retrospective descriptive multicentre study that included pediatric patients treated between 2010 and 2018 at four tertiary hospitals.Results Data were collected for 24 patients. The median age at diagnosis was 2.5 years (range 0.5-4.7). A total of 46 endoscopic procedures were performed. The endoscopic procedure was multiple in 63% of patients. Among the interventions, 76% were successful and 15% were unsuccessful. The recurrence rate was 57% and the median time to recurrence was 3.7 months (0.1-73). The efficacy did not differ significantly between the two methods at the first intervention and as a second-line treatment. The recurrence rate also did not differ significantly between the two methods. No complications were reported. The median followup was 19.8 months (1.7-61.7). ConclusionsIn this retrospective multicentre study, endoscopic management of gastroparesis by balloon dilatation or botulinum toxin was safe in children and seemed to be partially efficient within the first months. Symptoms recurred frequently and required repetition of the interventions.

One third of pediatric IBD patients who initially respond to infliximab (IFX) lose that response over time. This retrospective study, including 62 children treated with IFX from 2004 to 2017, aimed to identify factors associated with clinical flare. Ulcerative colitis, extreme body mass index, and lowest IFX trough levels were associated with clinical flare in the whole population. In Crohn disease patients, perianal disease was pejorative, while location proximal to ligament of Treitz was protective. Underweight patients probably correspond to the most severe cases who are more likely to relapse, with hypoalbuminemia responsible for lower systemic IFX availability. Obesity probably induces higher IFX clearance.