The utility of ERCP in children

Endoscopic retrograde cholangiopancreatography (ERCP) is a special endoscopic technique that enable the injection of contrast media into the bilio-pancreatic tree. Choledochal cysts are a common indication for ERCP: therapeutic treatment of biliary and pancreatic complications and morphologic evaluation of common biliopancreatic duct. Jaundice for choledochal strictures and choledocholitiasis represents indications for sphyncterotomy, stone extractions, dilations and stenting. Traumatic or post surgical biliary damages are other indications for therapeutic ERCP. In children, pancreatic indications are more common than those of the biliary ones. Chronic pancreatitis, idiopathic or malformative, can be diagnosed and treated with pancreatic sphyncterotomy, drainage or stent placement. Minor papilla sphyncterotomy can be detected in the partial or complete pancreas divisum. Endoscopic treatment of duodenal duplications, pancreatic post traumatic Wirsung leak, and pseudocysts are also described.