经内镜逆行胰胆管造影术在儿童胆胰疾病诊治中的应用价值

Efficacy and safety of endoscopic retrograde cholangiopancreatography for children with pancreaticobiliary diseases

摘要:

目的 探讨经内镜逆行胰胆管造影术（ERCP）用于儿童胆胰疾病诊治的安全性和有效性。方法 收集2007年9月至2016年8月期间南京鼓楼医院行ERCP诊治的年龄≤14岁的胆胰疾病患儿41例，回顾性总结操作完成情况、并发症发生情况及诊治结果。结果 41例患儿共行68例次ERCP，均采用深度镇静方式，其中诊断性ERCP 6例次（8.8％）、治疗性ERCP 62例次（91.2％）。仅1例次胆胰管汇流异常的患儿胆管插管未成功，ERCP操作成功率达98.5％（67／68）。总体并发症发生率为11.8％（8／68），均见于治疗性ERCP，包括7例次轻症胰腺炎和1例次发热，未出现出血、穿孔、死亡等严重并发症及麻醉相关并发症。32例（78.0％）患儿得到随访，随访时间2个月至6年，患儿生活质量良好，无不良后果。结论 ERCP对于有适应证的胆胰疾病患儿是一种安全、有效的诊疗方法。

Abstract:

Objective To assess the safety and efficacy of endoscopic retrograde cholangiopancreatography （ERCP） for children with pancreaticobiliary diseases. Methods Data of children under 14 years old who have underwent ERCP in Nanjing Drum Tower Hospital between September 2007 and August 2016 were reviewed for completion， complications and therapeutic methods. Results A total of 41 children underwent 68 ERCP， including 6（8.8％） diagnostic and 62（91.2％） therapeutic procedures. All procedures were performed under deep sedation. Cannulation failed in only 1 child with anomalous junction of pancreaticobiliary duct. The procedure success rate was 98.5％（67／68）. There were 8 adverse events， including 7 mild post-ERCP pancreatitis and 1 fever. Incidence of adverse event was 11.8％（8／68）. There was no such severe adverse event as bleeding， perforation， death， or other anesthesia related adverse event. Thirty-two children （78.0％） had follow-up， ranging from 2 month to 6 years. Children followed lived well with no long-term adverse event. Conclusion ERCP is an effective and safe procedure for the diagnosis and treatment of pancreaticobiliary diseases in children.