Evaluation of endoscopic retrograde cholangiopancreatography in Turkish children

Background:This study aimed to evaluate the indications, efficacy, and safety of endoscopic retrograde cholangiopancreatography (ERCP) in pediatric patients at a single center in Turkey between 2017 and 2021.Methods:A retrospective review was conducted on 50 children (mean age, 12.7 years; range, 1-18 years) who underwent 65 ERCP procedures. Data collected included patient demographics, indications for ERCP, procedural details, success rates, and complications. All procedures were performed using therapeutic duodenoscopes under conscious sedation administered by an anesthesiologist.Results:The primary indications for ERCP were biliary tract issues, including choledocholithiasis (52.3%) and chronic pancreatitis (18.5%). The overall cannulation success rate was 92.3%. Multiple therapeutic interventions, such as sphincterotomies and stent placements, were often required. The most common complication was post-ERCP pancreatitis, observed in 6.1% of cases, all of which were moderate. No fatalities or serious anesthesia-related adverse events were reported.Conclusion:ERCP is an effective and safe therapeutic procedure in pediatric patients when performed in collaboration with adult gastroenterologists, despite technical challenges such as the lack of pediatric-specific duodenoscopes. The findings highlight the need for specialized pediatric ERCP equipment and suggest that centralized ERCP facilities could enhance patient outcomes in Turkey.