Abstract

Endoscopic retrograde colangio-pancreatography (ERCP) in children is currently widespread and utilized, particularly for therapeutic indication, as in adulthood. ERCP considered efficacy and safe in children, if performed by expert endoscopists. In the last year, the incoming progress of magnetic resonance image (MRI), especially in collaborator pediatric patients, eliminated many diagnostic indications for ERCP, leaving therapeutic aims as in adults. In special situation, ERCP maintains a diagnostic value: study of pancreatobiliary junction, to rule out congenital malformation; definition of malign tumors such as rabdomyosarcoma in children, where intraductal biopsies allow definitive diagnosis; preoperative evaluation of biliary tree in patients non-collaborative for MRI with suspected choledocal cyst. Miniprobe endoscopic ultrasonography (EUS) with ERCP and linear EUS for bilio-pancreatic diseases have expanded the diagnostic field also in children affected by suspected biliary litiasis or biliary neoplasm. In pediatric biliary diseases, ERCP has the same therapeutic role as in adult: sphincterotomy, stricture dilations with balloon or rigid dilators, stones removal, stent placement in stricture and in leak. In this review, we would like to focus our attention on state of art and news about the role of this combined endocopic and radiologic procedure, in pediatric biliary diseases.

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