APPROACH TO THE DIFFICULTIES ASSOCIATED WITH PANCREATOBILIARY ENDOSCOPIC TREATMENT IN CHILDREN

Abstract

Pancreatobiliary endoscopy (PBE) on a child is a technically difficult and high-risk procedure with the possibility of severe postoperative complications. Due to the rarity of the performed procedure and a shortage of qualified specialists, several institutions lack the adequate infrastructure needed to conduct a PBE. However, despite lacking dedicated endoscopes and other devices in our institution, we regularly perform a relatively large number of PBEs on children. We employ standard endoscopes and devices for adult patients to perform PBE on children, under conscious sedation, in the presence of a pediatrician/pediatric surgeon. Procedures are performed smoothly in the operation theatre under general anesthesia with the aid of a well-constructed PBE performance system. In this article, we have elaborated on our methods of obtaining informed consent, anesthesia, procedural details, and the introduction of the PBE collaborationsystem in our institution. Furthermore, we have laid prime emphasis on addressing the emotional ordeal of the children undergoing the procedure, apart from the physical discomfort experienced by them.