BACKGROUND: ERCP experience in pancreatic disorders in children is limited. OBJECTIVE: This study evaluated the utility and efficacy of ERCP in children with pancreatic diseases at a tertiary care referral center. PATIENTS AND SETTINGS: Consecutive patients 18 years of age and younger who underwent ERCP for pancreatic diseases from January 2010 to June 2011 were identified. Indications, findings, interventions, adverse events, and outcomes were recorded. RESULTS: A total of 221 ERCPs were performed in 172 children (102 boys, mean ± standard deviation age 13.8 ± 3.2 years, 157 therapeutic). A total of 143 children (83.1%) had chronic pancreatitis (CP), 19 (11%) had recurrent acute pancreatitis (RAP), and 10 (5.8%) had acute pancreatitis (AP). Indications included pain (153, 89.4%), pancreatic fistula (11, 6.3%), symptomatic pseudocyst (4, 2.3%), and jaundice (3, 1.7%). In chronic pancreatitis patients, findings included a dilated and irregular main pancreatic duct (92, 64.3%), pancreatic duct (PD) calculi (76, 53%), dominant PD stricture (23, 16%), PD leak (7, 4.9%), pancreas divisum (35, 24.5%), and common bile duct (CBD) stricture (3, 2%). Therapeutic procedures included major papilla sphincterotomy (93, 65%), minor papilla sphincterotomy (32, 22.3%), PD stenting (77, 53.8%), and CBD stenting (3, 2.2%). PD stones larger than 5 mm were retrieved endoscopically after 57 extracorporeal shock wave lithotripsy sessions in 50 patients (34.9%). In patients with RAP, 6 (31.5%) had complete and 1 partial pancreas divisum. All underwent minor papillotomy. In patients with AP, 4 (40%) had stenting for PD leak, 2 (20%) underwent CBD clearance for biliary pancreatitis, and 4 (40%) had transpapillary pseudocyst drainage. During 13 ± 4.7 months (range 6-22 months) of follow-up, improvement of symptoms was seen in 143 of 172 (83%) patients. Procedure-related adverse events were seen in 8 (4.7%) patients. LIMITATIONS: Retrospective study. CONCLUSION: ERCP is a safe therapeutic option for pancreatic disorders in children.
BACKGROUND: ERCP experience in pancreatic disorders in children is limited. OBJECTIVE: This study evaluated the utility and efficacy of ERCP in children with pancreatic diseases at a tertiary care referral center. PATIENTS AND SETTINGS: Consecutive patients 18 years of age and younger who underwent ERCP for pancreatic diseases from January 2010 to June 2011 were identified. Indications, findings, interventions, adverse events, and outcomes were recorded. RESULTS: A total of 221 ERCPs were performed in 172 children (102 boys, mean ± standard deviation age 13.8 ± 3.2 years, 157 therapeutic). A total of 143 children (83.1%) had chronic pancreatitis (CP), 19 (11%) had recurrent acute pancreatitis (RAP), and 10 (5.8%) had acute pancreatitis (AP). Indications included pain (153, 89.4%), pancreatic fistula (11, 6.3%), symptomatic pseudocyst (4, 2.3%), and jaundice (3, 1.7%). In chronic pancreatitispatients, findings included a dilated and irregular main pancreatic duct (92, 64.3%), pancreatic duct (PD) calculi (76, 53%), dominant PD stricture (23, 16%), PD leak (7, 4.9%), pancreas divisum (35, 24.5%), and common bile duct (CBD) stricture (3, 2%). Therapeutic procedures included major papilla sphincterotomy (93, 65%), minor papilla sphincterotomy (32, 22.3%), PD stenting (77, 53.8%), and CBD stenting (3, 2.2%). PD stones larger than 5 mm were retrieved endoscopically after 57 extracorporeal shock wave lithotripsy sessions in 50 patients (34.9%). In patients with RAP, 6 (31.5%) had complete and 1 partial pancreas divisum. All underwent minor papillotomy. In patients with AP, 4 (40%) had stenting for PD leak, 2 (20%) underwent CBD clearance for biliary pancreatitis, and 4 (40%) had transpapillary pseudocyst drainage. During 13 ± 4.7 months (range 6-22 months) of follow-up, improvement of symptoms was seen in 143 of 172 (83%) patients. Procedure-related adverse events were seen in 8 (4.7%) patients. LIMITATIONS: Retrospective study. CONCLUSION: ERCP is a safe therapeutic option for pancreatic disorders in children.
Authors: Maisam Abu-El-Haija; Soma Kumar; Jose Antonio Quiros; Keshawadhana Balakrishnan; Bradley Barth; Samuel Bitton; John F Eisses; Elsie Jazmin Foglio; Victor Fox; Denease Francis; Alvin Jay Freeman; Tanja Gonska; Amit S Grover; Sohail Z Husain; Rakesh Kumar; Sameer Lapsia; Tom Lin; Quin Y Liu; Asim Maqbool; Zachary M Sellers; Flora Szabo; Aliye Uc; Steven L Werlin; Veronique D Morinville Journal: J Pediatr Gastroenterol Nutr Date: 2018-01 Impact factor: 2.839
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: David M Troendle; Douglas S Fishman; Bradley A Barth; Matthew J Giefer; Tom K Lin; Quin Y Liu; Maisam Abu-El-Haija; Melena D Bellin; Peter R Durie; Steven D Freedman; Cheryl Gariepy; Tanja Gonska; Melvin B Heyman; Ryan Himes; Sohail Z Husain; Soma Kumar; Mark E Lowe; Veronique D Morinville; Chee Y Ooi; Joseph Palermo; John F Pohl; Sarah Jane Schwarzenberg; Steven Werlin; Michael Wilschanski; M Bridget Zimmerman; Aliye Uc Journal: Pancreas Date: 2017-07 Impact factor: 3.327
Authors: Jasmin Felux; Ekkehard Sturm; Andreas Busch; Emanuel Zerabruck; Florian Graepler; Dietmar Stüker; Andreas Manger; Hans-Joachim Kirschner; Gunnar Blumenstock; Nisar P Malek; Martin Goetz Journal: United European Gastroenterol J Date: 2017-01-11 Impact factor: 4.623