PURPOSE: The management of chronic pancreatitis (CP) in children is challenging. We compare endoscopic retrograde cholangiopancreatography (ERCP) to operative therapy (OR). METHODS: The study involved review of patients younger than 18 years with CP who underwent ERCP or OR from 1973 to 2007. Follow-up was complete in 95% of patients (median, 6 years; range, 1-23 years). RESULTS: We identified 37 children with CP; 25 (68%) were managed by OR with 20 of these previously failing ERCP. Twelve (32%) were managed by ERCP alone. Mean follow-up was longer in the OR group (5.1 vs 2.1 years; P = .02). Patients with idiopathic pancreatitis (58% vs 13%; P = .04) and patients with a later onset of pancreatitis (12.0 vs 7.4 years; P = .002) were more likely to be managed with ERCP alone. The patients who underwent OR had a lower rate of recurrent pancreatitis (39% vs 75%; P < .0001), although this did not correlate to fewer hospitalizations or less narcotic use compared to ERCP alone. When patients who failed ERCP and progressed to OR were included in the ERCP alone group, ERCP was worse in recurrence (90% vs 39%; P < .0001) and rate of hospitalization (55% vs 33%; P = .04) compared to OR. CONCLUSION: Patients with CP managed by OR have a lower rate of recurrent pancreatitis and hospitalization compared to ERCP.
PURPOSE: The management of chronic pancreatitis (CP) in children is challenging. We compare endoscopic retrograde cholangiopancreatography (ERCP) to operative therapy (OR). METHODS: The study involved review of patients younger than 18 years with CP who underwent ERCP or OR from 1973 to 2007. Follow-up was complete in 95% of patients (median, 6 years; range, 1-23 years). RESULTS: We identified 37 children with CP; 25 (68%) were managed by OR with 20 of these previously failing ERCP. Twelve (32%) were managed by ERCP alone. Mean follow-up was longer in the OR group (5.1 vs 2.1 years; P = .02). Patients with idiopathic pancreatitis (58% vs 13%; P = .04) and patients with a later onset of pancreatitis (12.0 vs 7.4 years; P = .002) were more likely to be managed with ERCP alone. The patients who underwent OR had a lower rate of recurrent pancreatitis (39% vs 75%; P < .0001), although this did not correlate to fewer hospitalizations or less narcotic use compared to ERCP alone. When patients who failed ERCP and progressed to OR were included in the ERCP alone group, ERCP was worse in recurrence (90% vs 39%; P < .0001) and rate of hospitalization (55% vs 33%; P = .04) compared to OR. CONCLUSION:Patients with CP managed by OR have a lower rate of recurrent pancreatitis and hospitalization compared to ERCP.
Authors: Srinath Chinnakotla; David M Radosevich; Ty B Dunn; Melena D Bellin; Martin L Freeman; Sarah J Schwarzenberg; A N Balamurugan; Josh Wilhelm; Barbara Bland; Selwyn M Vickers; Gregory J Beilman; David E R Sutherland; Timothy L Pruett Journal: J Am Coll Surg Date: 2014-01-10 Impact factor: 6.113
Authors: Srinath Chinnakotla; Melena D Bellin; Sarah J Schwarzenberg; David M Radosevich; Marie Cook; Ty B Dunn; Gregory J Beilman; Martin L Freeman; A N Balamurugan; Josh Wilhelm; Barbara Bland; Jose M Jimenez-Vega; Bernhard J Hering; Selwyn M Vickers; Timothy L Pruett; David E R Sutherland Journal: Ann Surg Date: 2014-07 Impact factor: 12.969
Authors: D Kohoutova; A Tringali; G Papparella; V Perri; I Boškoski; J Hamanaka; G Costamagna Journal: United European Gastroenterol J Date: 2018-12-05 Impact factor: 4.623
Authors: Melena D Bellin; Gregory P Forlenza; Kaustav Majumder; Megan Berger; Martin L Freeman; Gregory J Beilman; Ty B Dunn; Timothy L Pruett; Michael Murati; Joshua J Wilhelm; Marie Cook; David E R Sutherland; Sarah J Schwarzenberg; Srinath Chinnakotla Journal: J Pediatr Gastroenterol Nutr Date: 2017-03 Impact factor: 2.839
Authors: Srinath Chinnakotla; Gregory J Beilman; David Vock; Martin L Freeman; Varvara Kirchner; Ty B Dunn; Timothy L Pruett; Stuart K Amateau; Guru Trikudanathan; Sarah J Schwarzenberg; Elissa Downs; Matthew Armfield; Karthik Ramanathan; David E R Sutherland; Melena D Bellin Journal: Ann Surg Date: 2022-06-28 Impact factor: 13.787