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

J. Stovicek, S. Hlava, R. Keil, J. Drabek, J. Lochmannova, P. Koptová, M. Wasserbauer, B. Frybova, J. Snajdauf, R. Kotalova, M. Rygl

. 2021 ; 2021 (-) : 9969825. [pub] 20210624

Language English Country Egypt

Document type Journal Article

Persistent link   https://www.medvik.cz/link/bmc22004186

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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$a Over a twenty-year period, we performed 255 ERCP procedures in infants aged up to 1 year. ERCP was indicated in cholestatic infants with suspicion of biliary obstruction. The most common diagnosis was biliary atresia (48%), choledochal cysts (13%), and choledocholithiasis (4%). The procedure complication rate was 13.7%. Hyperamylasemia occurred in 12.9%. More severe complications were rare-0.8% of ERCP procedure. There were no cases of postprocedural pancreatitis or death. Our study has proved that ERCP is a safe and reliable method in this age group. Its high specificity and negative predictive value for extrahepatic biliary atresia can prevent unnecessary surgeries in patients with normal bile ducts or endoscopically treatable pathologies.
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$a Hlava, Stepan $u Department of Internal Medicine, Charles University in Prague, 2nd Faculty of Medicine, University Hospital Motol in Prague, Prague, Czech Republic
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$a Keil, Radan $u Department of Internal Medicine, Charles University in Prague, 2nd Faculty of Medicine, University Hospital Motol in Prague, Prague, Czech Republic
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$a Drabek, Jiri $u Department of Internal Medicine, Charles University in Prague, 2nd Faculty of Medicine, University Hospital Motol in Prague, Prague, Czech Republic
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$a Koptová, Petra $u Department of Internal Medicine, Charles University in Prague, 2nd Faculty of Medicine, University Hospital Motol in Prague, Prague, Czech Republic
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$a Frybova, Barbora $u Department of Pediatric Surgery, Charles University in Prague, 2nd Faculty of Medicine, University Hospital Motol in Prague, Prague, Czech Republic
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$a Kotalova, Radana $u Department of Pediatry, Charles University in Prague, 2nd Faculty of Medicine, University Hospital Motol in Prague, Prague, Czech Republic
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$a Rygl, Michal $u Department of Pediatric Surgery, Charles University in Prague, 2nd Faculty of Medicine, University Hospital Motol in Prague, Prague, Czech Republic
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