| 단일기관에서의 소아 ERCP 10예에 대한 임상적 고찰 |
| 박진우ㆍ박상흠ㆍ이태훈ㆍ심윤숙ㆍ황순오ㆍ김상필ㆍ이준영ㆍ이세환ㆍ이창균ㆍ박도현*ㆍ이석호ㆍ정일권ㆍ김홍수ㆍ김선주 |
| 순천향대학교 의과대학 천안병원 소화기내과학교실, *울산대학교 의과대학 서울아산병원 소화기내과학교실 |
| A Single Institution's Experience of Ten Pediatric Patients with Endoscopic Retrograde Cholangiopancreatography |
| Jin Woo Park, M.D., Sang-Heum Park, M.D., Tae Hoon Lee, M.D., Yun Suk Shim, M.D., Soon Oh Hwang, M.D., Sang Pil Kim, M.D., Jun Young Lee, M.D., Seo Whan Lee, M.D., Chang Kwun Lee, M.D., Do Hyun Park, M.D.*, Suck Ho Lee, M.D., Il Kwun Chung, M.D., Hong Soo |
| Division of Gastroenterology, Department of Internal Medicine, Soonchunhyang University Cheonan Hospital, Soonchunhyang University College of Medicine, Cheonan, *Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea |
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| Abstract |
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Background/Aims:
ERCP is being used increasingly as a diagnostic and therapeutic tool for children with pancreaticobiliary disorders. Differences between thirteen pediatric ERCPs and adult ERCPs were reviewed with respect to their indications, method of anesthesia, choice of endoscope and complications.
Methods:
The medical records of 13 ERCPs for 10 children (age: 23 months to 14 years) done between 2005 and 2008 were reviewed retrospectively.
Results:
ERCP was indicated for gallstone pancreatitis (6), choledocholithiasis (3), and unexplained pain (1). The method of anesthesia was intravenous sedation with a single agent or a combination of midazolam, propofol or ketamine. The quality of sedation was satisfactory in 10 cases and unsatisfactory in three cases. These 3 cases were less than 8 years old and sedated with a combination of midazolam and propofol. Selective biliary cannulation was successful in 92.3% (12/13) of attempts. Therapeutic ERCP included sphincterotomy (4), endoscopic papillary balloon dilatation (3), and both (5). Complications occurred in 7.7% of attempts (1/13; 1 duodenal perforation) which was successfully managed by surgery.
Conclusions:
Pediatric ERCP is a feasible and useful technique. Special caution is needed, however, because of differences with adult ERCP in terms of the effectiveness of intravenous sedation, complications, and size of the gastrointestinal tract. (Korean J Gastrointest Endosc 2010;41:140-146)
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| Key Words:
ERCP, Children |
| 주요어:
ERCP, 소아 |
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