Endoscopic retrograde cholangiopancreatography in children

Abstract

Recently endoscopic retrograde cholangiopancreatography (ERCP) is developed much as one of the special examinations of the biliary tract. But ERCP in children have not been carried out, because of their particularity. Now, we performed this examination to two children under general anesthesia with nasal tracheal intubation with good results, and we discussed a few problems about ERCP in children. ERCP was originated first by Doubilet in 1951 then Hirschowitz observed the duodenum and Vater's papilla by using fiberscope in 1958, and McCune et al. succeeded retrograde pancreatography in 1968. In Japan, there were many reports about ERCP by Ohi and Takagi in 1969. In the next year other reports were published by Shindo, Ogoshi and Fujita. Moreover, many kinds of diagnostic methods and therapies have been contrived to nowadays. But there is no report concerning ERCP in children without Uragami's two cases. We examined ERCP in two cases by using Olympus JF-B3 (for adults) under general anesthesia with nasal tracheal intubation ; (One was a 6-years-old female, who was suspected congenital choledochal delatation, and her body weight was 22 kg and height was 124.5 cm. Another case was a 7-years-old male, who was suspected traumatic pancreatic cyst, and his body weight was 23 kg and height was 119 cm). The problems of this examination depend on the type of fiberscope and the cooperation of the children. Concerninng the type of fiberscope, we hope that a new and skillful type beneficial for children, but we know that we can examine children by means of the popular type of fiberscope for adults. When we use the popular type of fiberscope for adults to children, we must know deservedly the technical limitation, in which the children are required elder than age of 6, heavier than 20 kg body weight and higher than 110 cm height. Another problem is “anesthesia”. General anesthesia with nasal tracheal intubation is necessary to children for their particularity by all means, thus the operation of fiberscope will be easier, then the safety and effective examinations will be carried out. © 1980, Japanese Society of National Medical Services. All rights reserved.