Safety and long-term outcomes of endoscopic papillary balloon dilation in children with bile duct stones.

摘要

BACKGROUND: Although experience with diagnostic and therapeutic ERCP in children is growing, little is known about the safety and technical outcomes of endoscopic papillary balloon dilation (EPBD) in pediatric patients with bile duct stones (BDSs). OBJECTIVE: To assess the safety and long-term outcomes of EPBD in pediatric patients with BDSs. DESIGN: Case study. SETTING: Tertiary referral center. PATIENTS AND INTERVENTIONS: This study involved 5 children who had BDSs combined with gallstones who underwent EPBD. MAIN OUTCOME MEASUREMENTS: Successful EPBD, successful stone removal, procedure-related complications, and long-term outcomes. RESULTS: ERCP was successful in all cases, with cannulation and subsequent EPBD. Stone removal was performed in 1 session in all patients. No EPBD-related complications were observed in any patient. After EPBD, 1 patient subsequently underwent laparoscopic cholecystectomy for gallstones. The remaining 4 were followed without surgery. In 2 patients, gallstones were spontaneously passed from the bile duct into the duodenum. During the follow-up period, over a mean of 7.1 years (range 3.7-9.3 years), no recurrence of BDSs was observed in any patient. LIMITATIONS: Small number of patients. CONCLUSIONS: Although BDSs are rare in pediatric patients, EPBD may be a safe and effective technique for the management of such stones in some children.