Endosonography of the pancreatobiliary area in pediatric patients. The first experience

Abstract

Introduction. The diagnostics of malformations and diseases in the organs of pancreatobiliary area in children is an actual problem. An increase in the number of pediatric patients with pancreatobiliary anomalies, complications of cholelithiasis, acute and chronic pancreatitis requires the development of new techniques of non-invasive diagnostics which would allow to choose the optimal curative tactics.Material and methods. The article presents authors' experience of performing endosonography in 44 children, aged 2–17, during 2.5 years. Indications for endosonography were: complicated cholelithiasis, choledochal cyst, pancreatic duct dilatation, lithiasis of the Wirsung’s duct, cystic and solid formations in the pancreas and omental sac. Fine-needle aspirations under endosonography control were performed in 10 patients; transgastric drainage of pancreatic pseudocysts - in 6 children.Results. In all cases, endosonography turned out to be an informative diagnostic option. The curative tactics was changed in 21 (47.7%) patients after receiving endosonographic findings. Besides, such findings clarified anatomical and topographic features of organs in the pancreatobiliary zone in 15 (34.1%) patients; endosonographic findings helped to define the optimal volume of surgical intervention in 6 (13.6%) patients. There were no complications during diagnostic procedures. Bleeding into the lumen of pseudocyst was noted in a patient with transgastric drainage.Conclusion. Endosonography in children is an informative non-invasive technique for diagnosing malformations and diseases of the pancreatobiliary region because it allows to obtain the final picture of biliary and pancreatic ducts, of the site and nature of focal lesions in the pancreas, as well as to clarify indications for various interventions.