Diagnostic and Therapeutic Roles of Endoscopic Ultrasound in Pediatric Pancreaticobiliary Disorders

Abstract

Our study reports on a large pediatric EUS series for diagnostic and therapeutic pancreaticobiliary disorders, demonstrating the impact of diagnostic EUS and affording insights into novel EUS and combined EUS-ERCP therapeutic applications. We suggest considering EUS as a diagnostic and therapeutic tool in the management of pediatric pancreaticobiliary diseases.

Endoscopic drainage of pancreatic fluid collections: Long‐term outcomes in children

“…Our results are in accordance with the published case series depicting the favorable outcome of endoscopic drainage in children. [10][11][12]19,21 Clinical success was similar in pseudocysts and WON in the current study. Satisfactory outcomes in our study demonstrate that plastic stents are sufficient for draining pseudocysts and WON with minimal debris.…”

“…[10][11][12]19,21 Clinical success was similar in pseudocysts and WON in the current study. Our results are in accordance with the published case series depicting the favorable outcome of endoscopic drainage in children.…”

“…26 Therefore, although therapeutic EUS is largely safe in children, unplanned AE may occur and these patients should be preferably managed in centers equipped with multidisciplinary care. 21,27 Complications may be greater if drainage is carried out for WON as compared to pseudocysts and if direct endoscopic necrosectomy is done along with conventional drainage. 28 We did not require necrosectomy for any of our children as the amount of debris in children with WON was small.…”

EPC/HPSG evidence-based guidelines for the management of pediatric pancreatitis

“…Organ preservation should be the goal, but total pancreatectomy with islet autotransplant (TPIAT) should be considered as well 131,132 . EUS drainage via endoscopic cystgastrostomy has become the standard of care for drainage of large and symptomatic pancreatic pseudocysts in children 115,133,134 . Percutaneous or surgical drainage can be performed for a limited number of cases if endoscopic intervention has failed, unsuccessful or not available 135 .…”

Pediatric Endoscopy, Update 2020

“…The use of interventional EUS has been described for drainage of pancreatic fluid collection [122][123][124][125][126]. In particular, Zaheer Nabi et al described their experience in EUS-guided drainage of walled off necrosis using fully covered self-expanding metallic stents in 21 children with a technical and clinical success rates of 100% and 95%, respectively [127,128].…”