We analyzed 21, 807 colonoscopy procedures performed in patients with mean age of 11.9 (SD 4.8). Of the 21, 807 reports received during the study period, 56% did not include bowel prep quality and 12.7% did not include ASA classification. When bowel prep was reported, http://www.selleckchem.com/products/pifithrin-alpha.html the quality was described as excellent, good or fair in 80.2%. The overall ileal intubation rate was 69.4%, and 15.6% reported cecal intubation. Thus, 15% of colonoscopy procedures did not include complete examination (i.e., reach the cecum or ileum). When considering the proportion

of procedures not intended to reach the cecum (17.3%), the overall rate of complete examination increases to 89%. The rate of complete examination varied from 85% to 95% depending on procedure indication. Colonoscopy time was documented in 69.2% of cases. Significant variations in the practice of pediatric endoscopy are apparent, despite the use of a computerized report generator. Measurement of quality indicators in clinical practice can identify areas for quality improvement. “
“Use of endoscopic retrograde cholangiopancreatography (ERCP) is increasing in pediatrics for Navitoclax molecular weight biliary and pancreatic disorders. To date, all experiences of ERCP in children have been published by adult providers or surgeons. There is controversy over whether pediatric gastroenterologists should perform ERCP due to lower case volume and lack of

formal training programs. The purpose of this study was to demonstrate that appropriately trained pediatric gastroenterologists can perform ERCP for at least basic indications (Grade 1 and 2), safely and effectively as defined by ASGE practice standards. With IRB approval, ERCP experience at Children’s Medical Center Dallas (CMCD) from November 2006 to May 2012 was reviewed. All ERCPs were performed independently by a pediatric gastroenterologist with initial training of 200 supervised ERCPs (70% on children) followed by approximately 45 ERCPs annually at multiple sites for the past 6 years.

Only ERCPs on pediatric patients at CMCD for suspected choledocholithiasis were included for chart review. Outcomes were compared to accepted ASGE quality indicators for ERCP in adults. 154 ERCPs were performed, of which 65 (42%) were Guanylate cyclase 2C performed for the indication of suspected choledocholithiasis. Suspicion was based on clinical presentation in 46 (72%) patients, intraoperative cholangiogram in 18 (28%), and cholangiogram through cholecystostomy tube in 1 patient. Median age was 15.2 years (1 month -18.4 years). Median weight was 65kg (4kg-127kg). Forty-six (71%) were female, 20 (31%) were obese, 9 (14%) had sickle cell disease, and 1 had repaired cyanotic congenital heart disease. All cases were performed under general anesthesia. Biliary cannulation was successful in 65 (100%, ASGE threshold = 90%). All 65 patients underwent biliary sphincterotomy.