Endoscopic treatment of chronic pancreatitis in pediatric population: Long‐term efficacy and safety

Abstract

Background: Chronic pancreatitis (CP) in children is an inreasingly recognized disease. Objective: The purpose of study was to analyse the safety and long-term efficacy of endoscopic treatment in children with CP. Methods: Records of 38 patients aged <18 years, referred to the Digestive Endoscopy Unit at Catholic University, Fondazione Policlinico ''A. Gemelli'' IRCCS between 1991 and 2017, were reviewed. Abdominal pain, analgesia and number of episodes of acute pancreatitis in the pre-and post-endoscopic retrograde cholangiopancreatography (ERCP) period were evaluated. Need for surgery was assessed. Therapeutic intervention data and complications were interrogated. Results: In total 158 ERCPs were performed. Median post-ERCP follow-up was 7 years. The majority of patients had CP type IV (47%) and type Ib (37%) (Cremer's classification). Major papilla pancreatic sphincterotomy was performed in 47%, major and minor in 24% and minor in 29% of patients. Stones/plugs were removed in at least one ERCPs in 66% individuals. Eleven out of 38 patients had stricture of the pancreatic duct; these were dilated and stented in 5/11 and stented in 6/11. Five complications were recorded (3%). Severity and frequency of abdominal pain improved significantly; p < 0.001. Use of analgesia and number of episodes of acute pancreatitis decreased significantly; p < 0.001. One child required subsequent surgery. Conclusion: Endoscopic management of symptomatic CP in children is safe and effective.

Safety of endoscopic retrograde cholangiopancreatography in the pediatric population: a multicenter study

“…Endoscopic treatment is recommended for CP starting at 8 years old under the same conditions as in adults [5]. Studies have shown over 50% pain resolution or improvement, decreased pancreatitis occurrence and decreased need for care after endoscopic treatment [15][16][17]. In our study, more than half of children who underwent ERCP for symptomatic CP had symptom relief during follow-up.…”

[Retracted] The Clinical Application of Remimazolam Benzenesulfonate Combined with Esketamine Intravenous Anesthesia in Endoscopic Retrograde Cholangiopancreatography

“…In clinical application, propofol is characterized by a fast effect, short awakening time, and controllable anesthesia depth. However, it still has some disadvantages, such as large amounts of dosage and some adverse reactions, including obvious reduction in blood pressure, bradycardia, and apnea during deep sedation [ 32 ]. Liu et al [ 33 ] pointed out that the sedative effect of remimazolam benzenesulfonate was obviously better than that of midazolam during the diagnosis and treatment by colonoscopy.…”

Therapeutic Endoscopic Retrograde Cholangiopancreatography for Pediatric Hepato-Pancreato-Biliary diseases: A Systematic Review and Meta-analysis

“…Because of the diversity of diseases classi cation and complexity of speci c therapeutic treatment, sex and age strati cation were not included in the study. Barakat et al [17] (2021) Asenov et al [19] (2019) Wen et al [20] (2019) [22] (2019)…”