Long-term outcomes of therapeutic ERCP in pediatric patients with pancreas divisum presenting with acute recurrent or chronic pancreatitis

Wen, Ji; Li, Tao; Liu, Lei; Bie, Like; Gong, Bo

doi:10.1016/j.pan.2019.08.004

Cited by 20 publications

(28 citation statements)

References 36 publications

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“…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.…”

Section: Discussionmentioning

confidence: 59%

“…Mercier C 1 , MD; Pioche M 2 , MD, PhD; Albuisson E 3 , MD, PhD; Ponchon T 2 , MD, PhD; Gonzalez JM 4 , MD, PhD; Barthet M 4 , MD, PhD; Boytchev I 5 , MD; Vanbiervliet G 6 , MD, PhD; Fortier Beaulieu C 6 , MD; Prat F 7 , MD, PhD; Belle A 7 , MD; Branche J 8 , MD; Grandval P 9 , MD, PhD; Valats JC 10 , MD; Rudler F 10 , MD; Wallenhorst T 11 , MD; Koch S 12 , MD; Comte A 13 , MD; Williet N 14 , MD; Musquer N 15 , MD; Coron E 15 , MD, PhD; Derosiere A 16 , MD, PhD; Le Mouel JP 16 , MD; Schaefer M 17 , MD; Chabot C 1 , MD; Scheers I 18 , MD, PhD; Deprez P 19 , MD, PhD; Chevaux J-B 17 MD.…”

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confidence: 99%

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

et al. 2020

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Introduction: The aims of this retrospective multicentre study were to assess the technical success and adverse events of ERCP procedures in children in French and Belgian centres. Methods: All children aged one day to seventeen years who underwent ERCP between January 2008 and March 2019 in 15 tertiary care hospitals were retrospectively included. Results: 271 children underwent 470 ERCP procedures. Clinical long-term follow-up was available for 72% of our patients (340/470). The median age at intervention was 10.9 years. ERCP was therapeutic in 90% (423/470) and diagnostic in cases of neonatal cholestasis in 10% of the patients. The most common biliary indication was choledocholithiasis, and the most common pancreatic indication was chronic pancreatitis. Biliary cannulation was successful in 92% of cases (270/294); pancreatic cannulation, in 96% (169/176) of cases; and planned therapeutic procedures, in 91% (388/423) of cases. The overall complication rate was 19% (65/340). The most common complication was post-ERCP pancreatitis (PEP) in 12% (40/340) and sepsis in 5% (18/340) of cases. In the univariate analyses, pancreatic stent removal was protective against PEP (OR 0.1; 95% CI: 0.01-0.75, p=0.03), and sepsis was associated with liver transplantation history (OR 7.27, 95% CI: 1.7-31.05, p=0.01). Five patients had post-ERCP haemorrhage, and two had intestinal perforation. All complications were managed with supportive medical care. There was no procedure-related mortality. Conclusion: Our cohort demonstrates that ERCP can be performed safely with high success rates in many pancreaticobiliary diseases of children. The rate of adverse events was similar to that in previous reports.

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Section: Discussionmentioning

confidence: 59%

mentioning

confidence: 99%

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

et al. 2020

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“…Pediatric gastroenterologists independently implemented ERCP in 31% of facilities and EUS in only 5% of facilities. 4 Relatively large-scale studies over the past 5 years show that the number of ERCP and EUS procedures per year ranges from 1-92 and 4-19, respectively, as shown in Table 2 [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21] and Table 3. [22][23][24][25][26][27][28] In addition, these procedures were performed by pediatric gastroenterologists in limited institutions.…”

Section: Insufficient Frequency Of Ercp and Eus Procedures In Childrenmentioning

confidence: 99%

“…2) is a congenital malformation of the pancreas that causes clinical symptoms of pancreatitis, although its causality is debatable. 13,70,71 ERCP is the standard method for diagnosis, but noninvasive investigations such as MRCP and EUS may be used as an alternative. 70,72 Pancreatitis due to pancreas divisum can be mitigated using minor papilla sphincterotomy, minor papilla orifice balloon dilation, and trans-minor papilla dorsal duct stenting.…”

Section: Pancreas Divisummentioning

confidence: 99%

Endoscopic retrograde cholangiopancreatography and endoscopic ultrasound in children

Tagawa

Morita

Imagawa

et al. 2021

Digestive Endoscopy

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Gastrointestinal endoscopy is fundamental to diagnostic and therapeutic procedures in pediatric gastroenterology. In the decades since endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic ultrasound (EUS) for hepatobiliary and pancreatic disease were introduced into clinical practice, there has been increasing interest in these procedures, and practice guidelines and position papers that clearly define the role of ERCP and EUS in children have been published. Based on the distinction of endoscopy between children and adults, this review focuses on the current state of ERCP and EUS procedures in children, including the types of endoscopes used in children, general anesthesia and radiation exposure, biliary and pancreatic indications, considerations of education and training for ERCP and EUS procedures in children, and expectations for development of endoscopes for children.

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“…According to the INSPPIRE study, therapeutic ERCP was performed in 67% of children with chronic pancreatitis [102]. Patients with pancreas divisum (PD) may present with acute recurrent pancreatitis (ARP) or chronic pancreatitis (CP) [103].…”

Section: Indicationsmentioning

confidence: 99%

Pediatric Endoscopy, Update 2020

et al. 2019

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Optimal management of pediatric endoscopy requires a multidisciplinary approach. In most hospitals, endoscopy in pediatric patients is performed by conventional gastroenterologists and only a few centers have specialized pediatric gastroenterologists. This is due to the fact that the number of pediatric gastroenterologists is limited and not all of them are experienced in endoscopic techniques. However, there are also some pediatric centers offering a high-quality and high-volume endoscopy service provided by very experienced pediatric gastroenterologists. Up to now, the literature on pediatric endoscopy is rather sparse. In this article, we describe current knowledge and practice of endoscopic procedures in pediatric patients, which should be relevant for both the adult and pediatric gastroenterologists.

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Long-term outcomes of therapeutic ERCP in pediatric patients with pancreas divisum presenting with acute recurrent or chronic pancreatitis

Cited by 20 publications

References 36 publications

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

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

Endoscopic retrograde cholangiopancreatography and endoscopic ultrasound in children

Pediatric Endoscopy, Update 2020

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