The following is a summary of “Technical Outcomes in Pediatric Endoscopic Retrograde Cholangiopancreatography: Data from an International Collaborative” published in the December 2022 issue of Pediatric Gastroenterology and Nutrition by Troendle et al.

Endoscopic retrograde cholangiopancreatography (ERCP) in adults has been studied a lot through multicenter prospective studies. However, there are no similar studies on children. The Pediatric ERCP Database Initiative (PEDI) is a group of centers working together to look at the reasons for and technical results of ERCPs in children. In this prospective cohort study, data were collected from 15 centers that did ERCPs on children. For each ERCP that was done, a pre-procedure, procedure, 2-week follow-up, and adverse event form were filled out. Researchers used both univariate and stepwise linear regression to find the factors linked to technically successful procedures and bad things that happened.

Between May 1, 2014, and May 1, 2018, 1,124 ERCPs were done on 857 people. The average age was 13.5 years old (IQR: 9.0–15.7 years). Procedures were technically successful in most cases (90.5%). Procedures with biliary indications were more likely to be successful [odds ratio (OR): 4.2], while native papilla anatomy and children younger than 3 years old were less likely to be successful (OR 0.3). When pancreatic cannulation was done through the major papilla (89.6%, P<0.0001) or the minor papilla (71.2%, P<0.0005), it was more often successful than biliary cannulation (95.9%). The most common side effects were pancreatitis after ERCP (5%), pain that wasn’t caused by pancreatitis (1.8%), and bleeding (1.2%). Risk factors for each of these conditions were found.

This large prospective study shows that ERCP works well and is safe for children. Furthermore, it shows how PEDI can be used to evaluate the technical results of pediatric ERCPs and how it could be used in future studies of pediatric ERCPs.