TABLE 5.

Cases required surgical interventions after therapeutic endoscopic retrograde cholangiopancreatography (ERCP).

Study
Mercier et al. (11)	Additional treatments were needed in 12% (49/394) of cases: surgery in 61% of those cases. Cholecystectomy was performed on 64% (56/87) of the patients who needed an ERCP for choledocholithiasis.
Asenov et al. (25)	2 patients (8%) underwent surgical treatment for not achieving the therapeutic effect. Patient 1 was a 13-year-old boy, PD was found to be the cause. ST of the minor papilla was performed. The effect of the procedure was not permanent, and the patient underwent surgery. Patient 2 with a CBD stone of 2-cm diameter. The therapeutic effect was not achieved. The procedure was abandoned due to limited space for maneuvering the duodenoscope and lithotripter in the duodenum.
Harputluoglu et al. (26)	Endoscopic retrograde cholangiopancreatography (ERCP) and transhepatic biliary interventions (PTBI) were not successful in only 1 living donor liver transplantation (LDLT) patient with stricture. This patient underwent surgical treatment for biliary complications.
Wen et al. (27)	A 10-year-old girl who had CP. MRCP findings: Dorsal duct dilation, Pancreatic stone. This patient underwent pancreaticojejunostomy for failing cannulation via the minor papilla.
Kohoutova et al. (29)	1 patient underwent subsequent surgery (hepaticojejunoanastomosis) for refractory bile duct stricture.
Czubkowski et al. (13)	5 patients underwent hepaticojejunostomy and 3 patients required retransplantation (ReLTx). 1 intramural duodenal hematoma requiring surgery. 2 of these patients had important risk factors such as ABO incompatible donor, autoimmune hepatitis (AIH) relapse, and HBV coinfection.
Dechêne et al. (32)	A 13-month-old child required surgical revision for symptomatic duodenal hematoma 48 h after ERCP.
Kargl et al. (33)	2 (2/12) patients with significant stenosis of the pancreatic duct in whom cannulation and stenting were technically impossible underwent open surgical drainage procedures.
Agarwal et al. (34)	2 (2/147) underwent a surgical drainage procedure. Patient 1 had a severe refractory main pancreatic duct head (MPD) stricture. Patient 2 had extensive large PD calculi that were not amenable to extracorporeal shock wave lithotripsy (ESWL).
Oracz et al. (35)	10 patients underwent surgery after ERCP because of unsatisfactory results of stenting therapy. Subtotal pancreatectomy was performed in 3 children, and pancreatic tail resection with Roux-en-Y internal drainage was conducted in 7 cases.
Tsuchiya et al. (16)	11 patients who received a stent underwent excision of the extrahepatic bile duct, endoscopic therapy was considered pre-operative management. 1 patient recurred abdominal pain 18 days after endoscopic drainage. The findings during surgery supported the protein plug theory and verified another rare cause of obstruction involving fatty acid calcium stones.
Limketkai et al. (37)	1 patient underwent surgical intervention after 3 ERCP attempts were unsuccessful in extracting a large pancreatic duct stone.
Otto et al. (41)	41 patients underwent laparoscopic (n = 35) or open (n = 6) cholecystectomy after ERCP. The cholecystectomies included 17 performed for patients who had cholelithiasis without pancreatitis, including 2 cholecystectomies for patients younger than 10 years. The other indications for cholecystectomy after ERCP were acute gallstone pancreatitis (n = 10), choledocholithiasis (n = 8), chronic idiopathic pancreatitis (n = 4), chronic cholecystitis (n = 1), and biliary atresia (n = 1). 6 patients required exploratory laparotomy: 5 for drainage or debridement of pancreatic pseudocysts and 1 for excision of a choledochal cyst. 6 patients underwent Roux-en-Y hepaticojejunostomy after ERCP for bile duct obstruction: 3 for pancreatic pseudocyst and 1 each for choledochal cyst, cholangitis, and biliary atresia. Distal pancreatectomy was performed in 3 cases: traumatic pancreatitis in 2 cases and acute pancreatitis with pseudocyst in 1 case.
Jang et al. (42)	Intestinal perforation developed in 2 patients. 1 with perforation of the CC wall and bile leakage, underwent an emergency operation. Bile duct dilation improved in 2 such patients, both of whom underwent laparoscopic cholecystectomy.
Li et al. (18)	5 (11.6%) patients received surgical interventions, including pancreaticojejunostomy procedure (n = 3), Leger’ s procedure (n = 1), and “pancreatic head resection” in another hospital (n = 1) because of intractable pain (n = 1) and recurrent pain due to failure of pancreatitic duct stone extractions (n = 4). All five patients had histological evidence of CP.
Issa et al. (17)	36 patients had ERCP with sphincterotomy and stone extraction and 34 of them subsequently underwent laparoscopic cholecystectomy. This sequential approach is safe and effective for the management of children with cholelithiasis and choledocholithiasis.
Varadarajulu et al. (45)	A 9-year-old child with annular pancreas and chronic pancreatitis, the stent could not be inserted through a dominant stricture in the head of the pancreas, and surgery was recommended.