Endoscopic retrograde cholangiopancreatography (ERCP) is an important minimally invasive interventional therapy for pancreatobiliary diseases. Compared with adults, children have smaller anatomical structure of biliary and pancreatic duct, narrower operating space, and greater sensitivity to trauma and radiation, resulting in higher technical difficulty and stricter risk control requirements for ERCP interventional therapy in children. In recent years, pediatric ERCP interventional therapy has evolved from an adjuvant therapy to a dominant treatment with expanding indications. It has been widely used in the treatment of congenital pancreatobiliary malformations, complex pancreatobiliary diseases, pancreatic pseudocysts, and other conditions. A series of standardized interventional treatment regimens have been established, including endoscopic sphincterotomy, pancreatobiliary duct dilation, stent implantation, and lithotomy. These procedures can precisely relieve obstruction caused by the lesion, alleviate clinical symptoms, reduce disease recurrence, significantly decrease the trauma associated with traditional open surgery, and improve the prognosis of children. Meanwhile, the formulation of individualized treatment regimens, the refined optimization of minimally invasive techniques, and the synergistic application of ERCP with other minimally invasive techniques such as cholangioscopy and endoscopic ultrasound have further enhanced the success rate of interventional therapy. In addition, the application of ERCP in preoperative pancreatobiliary stent implantation to prevent intraoperative injury and minimally invasive intervention for postoperative complications has further extended its therapeutic value. This paper reviews the application progress on ERCP interventional therapy in children.

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