In‐hospital Pediatric Endoscopic Retrograde Cholangiopancreatography Is Associated With Shorter Hospitalization for Children With Choledocholithiasis

Bonasso, Patrick C.; Gurien, Lori A.; Staszak, Jessica; Gowen, Marie E.; Troendle, David M.; Odiase, Eliane; Lazar, L; Ruan, Wenly; Barth, Bradley; Williams, Regan F.; Dassinger, Melvin S.

doi:10.1097/mpg.0000000000002102

Cited by 10 publications

(7 citation statements)

References 21 publications

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“…This could have led to a longer stay over the weekend for postprocedure care and with less weekend discharges. Similar observation was also made in a large multicenter retrospective study in pediatric patients with choledocholithiasis where LOS was higher in patients requiring transfer to another facility because of lack of an in-house biliary endoscopist (22). The study also described a higher percentage of patients having a preendoscopy MRI in the group of patients requiring transfer to another facility for ERCP.…”

Section: Discussionsupporting

confidence: 80%

Retrospective Multicenter Matched Controlled Comparison of Endoscopic Retrograde Cholangiopancreatography in Pediatric Patients

Shah

Cohen

Mekaroonkamol

et al. 2020

J. pediatr. gastroenterol. nutr.

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Introduction:This study was designed to evaluate outcomes in pediatric patients undergoing endoscopic retrograde cholangiopancreatography (ERCP) as compared with an American Society of Gastrointestinal Endoscopy (ASGE) complexity grade-matched adult cohort.Method:In this retrospective case-control study, ERCPs performed in pediatric patients from January 2008 to December 2018 in 2 tertiary referral hospitals were compared with a complexity-matched adult control group with similar procedural indications. Primary outcomes included the clinical success rate, technical success rate, and complication rate. Secondary outcomes included postprocedural admission rates, mode of sedation, procedure time, fluoroscopy time, hospitalization length, and the number of repeat procedures.Results:Two hundred thirty-two ERCPs performed in 110 pediatric patients (average age 13.3) and 318 ERCPs performed in 160 ASGE grade-matched adult controls (average age 47.2 years) were analyzed. All procedures were therapeutic. There was no difference in the technical success rate (P = 0.2), clinical success rate (P = 0.5), complication rates (P = 0.1), and fluoroscopy time (P = 0.4), between the pediatric and adult cohorts. General anesthesia use and length of stay were significantly higher in the pediatric group (P = 0.0001). In subgroup analysis, technical (P = 0.2) and clinical success (P = 0.2) as well as complication rates (P = 0.6) were comparable between patients 10 years or less and patients 11 to 18 years within pediatric cohort.Conclusions:ERCP in pediatric cohorts appears to be safe and effective with equivalent outcomes relative to an ASGE complexity-matched adult cohort. Pediatric patients are more likely to require general anesthesia and have a longer average length of stay relative to adult controls.

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Section: Discussionsupporting

confidence: 80%

Retrospective Multicenter Matched Controlled Comparison of Endoscopic Retrograde Cholangiopancreatography in Pediatric Patients

Shah

Cohen

Mekaroonkamol

et al. 2020

J. pediatr. gastroenterol. nutr.

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“…The exact epidemiologic data of choledocholithiasis incidence in neonates and infants are missing, but it can be expected to be far less than 1 in 5000 [ 13 ], and in most cases, it is asymptomatic. Patients with symptomatic choledocholithiasis benefit from ERCP availability, and their length of stay in hospitals is shorter than without ERCP therapy [ 14 ].…”

Section: Discussionmentioning

confidence: 99%

Conjugated Hyperbilirubinemia in Infants: Is There Still a Role for ERCP?

Šťovíček

Hlava

Keil

et al. 2021

Canadian Journal of Gastroenterology and Hepatology

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Over a twenty-year period, we performed 255 ERCP procedures in infants aged up to 1 year. ERCP was indicated in cholestatic infants with suspicion of biliary obstruction. The most common diagnosis was biliary atresia (48%), choledochal cysts (13%), and choledocholithiasis (4%). The procedure complication rate was 13.7%. Hyperamylasemia occurred in 12.9%. More severe complications were rare‐0.8% of ERCP procedure. There were no cases of postprocedural pancreatitis or death. Our study has proved that ERCP is a safe and reliable method in this age group. Its high specificity and negative predictive value for extrahepatic biliary atresia can prevent unnecessary surgeries in patients with normal bile ducts or endoscopically treatable pathologies.

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“…Underlying conditions and the performance of ERCP procedures both lead to the longer hospital stay and higher medical cost in girls. A recent study stated that the children with choledocholithiasis underwent ERCP before cholecystectomy may have longer LOS if not having available ERCP proceduralists (34). Similar situation was also noted in Taiwan, and it further supports our argument.…”

Section: Discussionmentioning

confidence: 99%

Epidemiology of Pediatric Acute Pancreatitis in Taiwan

Cheng

Yang²,

Tsai³

et al. 2019

J. pediatr. gastroenterol. nutr.

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Objective:Pediatric acute pancreatitis (AP) may be different from adult AP in various respects. This study focuses on the epidemiology and medical resource use of pediatric AP in Taiwan.Methods:Patients aged 0 to 18 years with AP were identified from the Taiwan National Health Insurance Research Database based on the International Classification of Diseases, Ninth Revision code of AP 577.0. The medical resource use was measured by length of hospital stay and hospital charges.Results:Between 2000 and 2013, a total of 2127 inpatient cases of pediatric AP were collected, which represented a hospitalization rate of 2.83 per 100,000 population. The incidence by age had 2 peaks, the first peak was at age 4 to 5 years old, and the second one started rising from 12 to 13 years old until adulthood. The incidence by year increased from 2.33 to 3.07 cases per 100,000 population during the study period. The average hospital stay is steady, but the medical cost is increasing. Girls have longer hospital stays, higher medical expenditures, more use of endoscopic retrograde cholangiopancreatography possibly due to more comorbidities with biliary tract diseases than boys (P < 0.05). The mortality in cases of AP is mostly associated with systemic diseases rather than AP itself.Conclusions:The incidence of pediatric AP in Taiwan is in a rising trend. There are gender differences in length of hospital stay, medical costs, use of endoscopic retrograde cholangiopancreatography and comorbidities.

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In‐hospital Pediatric Endoscopic Retrograde Cholangiopancreatography Is Associated With Shorter Hospitalization for Children With Choledocholithiasis

Cited by 10 publications

References 21 publications

Retrospective Multicenter Matched Controlled Comparison of Endoscopic Retrograde Cholangiopancreatography in Pediatric Patients

Retrospective Multicenter Matched Controlled Comparison of Endoscopic Retrograde Cholangiopancreatography in Pediatric Patients

Conjugated Hyperbilirubinemia in Infants: Is There Still a Role for ERCP?

Epidemiology of Pediatric Acute Pancreatitis in Taiwan

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