Endoscopic Retrograde Cholangiopancreatography in Bangladeshi Children: Experiences and Challenges in a Developing Country

Rashid, Rafia; Arfin, Md Samsul; Karim, Asm Bazlul; Alam, Muhammad Baharul; Mahmud, Salahuddin

doi:10.5223/pghn.2022.25.4.332

Cited by 3 publications

(1 citation statement)

References 18 publications

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“…Plastic is chosen for shortterm use to avoid problems such as infection, blockage, and breakage that could happen with long-term use. 1,2 While the procedure has advanced with better materials and equipment, a persistent challenge is the unintentional neglect or long-term retention of stents, requiring advanced interventions to fix them. 3 The way health-care systems are structured affects how stenting is managed.…”

Section: Introductionmentioning

confidence: 99%

Complications and retrieval of forgotten biliary stents: A clinical insight

Sreedevi Sunkara,

Manoj Kumar Katragadda,

Pandu Ranga Kumari Motepalli

et al. 2024

Asian J Med Sci

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Background: Endoscopic biliary stenting is a common procedure in gastroenterology that uses plastic stents for short-term bile drainage. Aims and Objectives: This study explores the occurrence and consequences of forgotten or retained biliary stents. Materials and Methods: Conducted at King George Hospital in Visakhapatnam over 8 months, the study includes 12 patients with forgotten biliary stents. Diagnostic confirmation used X-rays, abdominal ultrasound, and magnetic resonance cholangiopancreatography. Four patients faced complications such as fractured distal pigtails and blocked stents, making retrieval challenging through standard methods like endoscopic retrograde cholangiopancreatography (ERCP) and cholangioscopy. Results: The study involved 12 patients (median age: 48 years), with choledocholithiasis being the main reason for stent placement in 10 cases (83.3%). On average, patients showed symptoms 31.3 months after stenting, mostly presenting with cholangitis (83.3%). Stent removal was successful in 8 cases (66.6%) using ERCP, while advanced procedures like cholangioscopy or surgery were needed in the rest. No mortality was reported. Conclusion: Conducted during the COVID-19 pandemic, this study reveals a rise in neglected plastic biliary stents. Cholangitis, often with common bile duct stones, was a common complication. Standard ERCP techniques were less effective in cases with complicated stents, requiring alternative approaches like cholangioscopy or surgery. The cases emphasize the urgency of timely stent retrieval and the need to improve management protocols to prevent complications.

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Section: Introductionmentioning

confidence: 99%

Complications and retrieval of forgotten biliary stents: A clinical insight

Sreedevi Sunkara,

Manoj Kumar Katragadda,

Pandu Ranga Kumari Motepalli

et al. 2024

Asian J Med Sci

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Indications, success, and adverse event rates of pediatric endoscopic retrograde cholangiopancreatography (ERCP): a systematic review and meta-analysis

Hosseini,

Sohouli,

Sharifi

et al. 2023

BMC Pediatr

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Background To improve knowledge on endoscopic retrograde cholangiopancreatography (ERCP) in children, we aimed to study the proportion of indications, success rate and complication of ERCP. Methods We performed a systematic search of all articles published up to December 2022 in the following databases: Cochrane Library, PubMed (MEDLINE) and Scopus. The meta-analysis was performed using a random-effects model. Heterogeneity was determined by the I2 statistics and the Cochrane Q test. The included data were analyzed to identify the proportion of indications, success rate and complications of ERCP in children. Results Based on data from 52 studies with a total of 5624 participants, the most common indications for ERCP in children were biliary [48% (95% CI: 0.40 - 0.57; I2 = 98.17%, P < 0.001)] and both biliary and pancreatic [41% (95% CI: 0.33 - 0.49; I2 = 98.27%, P < 0.001)]. The success rate of ERCP was 95% (95% CI: 0.94 - 0.96; I2 = 82.53%, P < 0.001) with the overall complication rate of 7% (95% CI: 0.05 - 0.09; I2 = 82.06%, P < 0.001). The pooled estimate for the incidence of post ERCP pancreatitis was 4% (95% CI: 0.03 - 0.06; I2 = 85.46%, P < 0.001) and the bleeding was 0% (95% CI: 0.0 - 0.0; I2 = 28.21%, P = 0.03). Conclusions ERCP appears to be performed safely in children with a similar success rate as in the adult population.

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Analysis of the efficacy and safety of endoscopic retrograde cholangiopancreatography for the treatment of pediatric pancreatobiliary diseases

Wang,

Kong,

et al. 2024

World J Gastrointest Surg

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BACKGROUND Traditional surgical procedures are highly invasive and risky for children with pancreatic and biliary diseases. Endoscopic retrograde cholangiopancreatography (ERCP) has been used mostly in adults because it is a safe and effective surgical procedure. Its application in children will contribute to the treatment and prognosis of children with pancreatic and biliary diseases. AIM To analyze the efficacy and safety of ERCP for the treatment of pediatric pancreatobiliary diseases. METHODS A retrospective study was performed using the medical records of 101 pediatric patients who received treatment for pancreatobiliary diseases at Children’s Hospital Capital Institute of Pediatrics from April 2022 to April 2024. The patients were divided into an observation group (n = 52, treated with ERCP) and a control group (n = 49, treated with traditional surgical methods). Diagnostic and therapeutic outcomes of ERCP were statistically analyzed. Treatment efficacy, time to resume eating, and hospital stay duration were compared between the two groups. Indicators of liver function were monitored preoperatively and one week postoperatively. Dynamic changes in C-reactive protein (CRP) and serum amylase levels were assessed preoperatively and at 6 and 24 hours postoperatively. Postoperative complications were also compared. Logistic multivariate regression was used to analyze the independent effect of ERCP on outcomes. RESULTS For the observation group, 36 and 16 patients were diagnosed with biliary and pancreatic diseases, respectively. Compared with the control group, the observation group exhibited a higher overall effective rate (P < 0.05), shorter times to resume eating, shorter hospital stays (P < 0.05), and significantly improved postoperative liver function (P < 0.05). CRP and serum amylase levels were significantly increased in both groups at 6 and 24 hours postoperatively (P < 0.05), but were significantly lower in the observation group (P < 0.05). The observation group also had a lower incidence of complications (P < 0.05). ERCP was an independent factor affecting treatment efficacy, length of hospital stay, total bilirubin, aspartate aminotransferase, and alanine aminotransferase, CRP, serum amylase, and the occurrence of complications in children with pancreaticobiliary diseases (P < 0.05). CONCLUSION ERCP effectively enhances the treatment efficacy of pediatric pancreatobiliary diseases, with a reduced inflammatory response, faster postoperative recovery, and fewer complications. ERCP is a safe and effective diagnostic and therapeutic method for pediatric pancreatobiliary diseases.

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Endoscopic Retrograde Cholangiopancreatography in Bangladeshi Children: Experiences and Challenges in a Developing Country

Cited by 3 publications

References 18 publications

Complications and retrieval of forgotten biliary stents: A clinical insight

Complications and retrieval of forgotten biliary stents: A clinical insight

Indications, success, and adverse event rates of pediatric endoscopic retrograde cholangiopancreatography (ERCP): a systematic review and meta-analysis

Analysis of the efficacy and safety of endoscopic retrograde cholangiopancreatography for the treatment of pediatric pancreatobiliary diseases

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