目的 探讨内镜逆行胰胆管造影术（endoscopic retrograde cholangiopancreatography，ERCP）在儿童胰胆管合流异常（pancreaticobiliary maljunction，PBM）诊治中的安全性和有效性。 方法 收集2012年11月至2022年9月在南京大学医学院附属鼓楼医院消化科行ERCP诊治的年龄≤14岁的40例PBM患儿资料，回顾性总结PBM分型、ERCP诊治情况、不良事件发生率及转归情况。 结果 19例PBM患儿为胰管汇入胆管（P-B）型，17例为胆管汇入胰管（B-P）型，4例为复杂型。40例PBM患儿共行50次治疗性ERCP，其中48次操作成功，1次ERCP插管失败，后改行1次辅助对接的内镜逆行胰管造影术。术后无出血、穿孔、死亡等严重并发症。34例（85%）患儿得到随访，其中14例进一步行外科手术，20例继续内科保守治疗，恢复均可。 结论 ERCP是儿童确诊PBM的金标准，也是一种安全有效的治疗手段。 Objective To investigate the safety and effectiveness of endoscopic retrograde cholangiopancreatography (ERCP) for the diagnosis and treatment of pediatric pancreaticobiliary maljunction (PBM). Methods Data of 40 pediatric patients under 14 with PBM diagnosed and treated by ERCP at Department of Gastroenterology, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School from November 2012 to September 2022 were collected. PBM types, ERCP-related diagnosis and treatment, adverse events and prognosis were retrospectively analyzed. Results Nineteen cases were P-B type (joining of common bile duct with pancreatic duct), 17 were B-P type (joining of pancreatic duct with common bile duct), and 4 were complex type. Forty children with PBM underwent 50 ERCP-related operations, among which 48 procedures succeeded. One case failed during cannulation of ERCP, replaced by rendezvous-assisted endoscopic retrograde pancreatography (RV-ERP) afterwards. There were no serious postoperative adverse events such as bleeding, perforation or death. Thirty-four patients (85%) were followed up successfully, among which 14 underwent further surgery and 20 continued conservative treatment. Conclusion ERCP is the golden standard to diagnose pediatric PBM, and it is also safe and effective treatment for PBM.
Value of endoscopic retrograde cholangiopancreatography for the diagnosis and treatment of pediatric pancreaticobiliary maljunction
Objective To investigate the safety and effectiveness of endoscopic retrograde cholangiopancreatography (ERCP) for the diagnosis and treatment of pediatric pancreaticobiliary maljunction (PBM). Methods Data of 40 pediatric patients under 14 with PBM diagnosed and treated by ERCP at Department of Gastroenterology, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School from November 2012 to September 2022 were collected. PBM types, ERCP-related diagnosis and treatment, adverse events and prognosis were retrospectively analyzed. Results Nineteen cases were P-B type (joining of common bile duct with pancreatic duct), 17 were B-P type (joining of pancreatic duct with common bile duct), and 4 were complex type. Forty children with PBM underwent 50 ERCP-related operations, among which 48 procedures succeeded. One case failed during cannulation of ERCP, replaced by rendezvous-assisted endoscopic retrograde pancreatography (RV-ERP) afterwards. There were no serious postoperative adverse events such as bleeding, perforation or death. Thirty-four patients (85%) were followed up successfully, among which 14 underwent further surgery and 20 continued conservative treatment. Conclusion ERCP is the golden standard to diagnose pediatric PBM, and it is also safe and effective treatment for PBM.
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