Pancreatic Disorders

Uç, Aliye; Fishman, Douglas S.

doi:10.1016/j.pcl.2017.01.010

Cited by 45 publications

(61 citation statements)

References 87 publications

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“…The paucity of data on pediatric ERCP in comparison to adult ERCP may be explained by the low incidence of biliary and pancreatic diseases in the pediatric population and the lack of endoscopic recourse. However, pancreaticobiliary diseases have become increasingly recognized in children [30]. transplantation and suggests that antibioprophylaxis should be used in this particular setting.…”

Section: Accepted M Manuscriptmentioning

confidence: 99%

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: Accepted M Manuscriptmentioning

confidence: 99%

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

et al. 2020

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“…CP in children, an increasingly recognized disease, can interfere with the psychophysical development of such an individual significantly. 1,3,7,17 The possibility to influence abdominal pain and episodes of acute pancreatitis, associated with impaired nutrition, need for admissions and need for surgery, is an imperative in patients with CP, especially in the pediatric cohort. Our study looked at the safety and long-term efficacy of therapeutic ERCP in children and adolescents with CP.…”

Section: Discussionmentioning

confidence: 99%

“…Chronic pancreatitis (CP), a pathological fibroinflammatory condition of the pancreas which develops in individuals with genetic, environmental, and/or other risk factors, used to be diagnosed very rarely in the pediatric population; nevertheless, it has become increasingly recognized recently. [1][2][3] Irreversible structural changes result in pain syndrome (recurrent episodes or persistent pain) and can progress to exocrine and/or endocrine pancreatic insufficiency. 1,4 Gene mutations (including PRSS1, SPINK1, CFTR and CTRC mutations) and anatomical variations of the pancreatic ducts are reported to be the most typical risk factors in the pediatric population with CP.…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2019

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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.

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“…Other risk factors include hypertriglyceridemia, hypercalcemia, drugs, infections, trauma, post ERCP, tumors, pancreatic divism, and some cases are also idiopathic. 3,4 Drugs are considered to be the rare cause of acute pancreatitis. However 525 different drugs are listed in the World Health Organization (WHO) which may leads to AP.…”

Section: Introductionmentioning

confidence: 99%

Acute Pancreatitis;

Abbasi¹,

Abid²

2019

TPMJ

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Objectives: To determine the clinical outcome of acute pancreatitis in relation with major etiologies (Gallstones, Alcohol, and Drugs). Study Design: Cross sectional hospital based study. Setting: Aga Khan University Hospital. Period: 16 years (from 1st January 2001 to 30th June 2016). Methods: All patients with acute pancreatitis admitted. Major risk factors of pancreatitis such as gallstones, alcohol, and drugs were evaluated and outcomes assessed for the development of complications and mortality. Results: We evaluated 3049 patients with acute pancreatitis, the causative agents found, 80.35% (N = 2450), followed by Alcohol 13.05% (N = 398) and drugs 6.59% (N = 201), respectively. Patients with alcohol abuse were relatively older 53.74 years compared to patients with gallstones 39.54 years and drugs induced 43.26 years AP. Among them, the overall complication rate was 5.05% (N = 155). The most common complication was development of sepsis 45.8% (N = 71) and the overall mortality rate observed was 0.91% (N = 28). Conclusions: Gall stones are the leading cause of acute pancreatitis while drugs are the rare cause, however in significant number of patients cause remained obscure. Based on the above results patients with drug induced pancreatitis have good outcome as compared to gall stones and alcohol induced acute pancreatitis, however further studies warranted.

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Pancreatic Disorders

Cited by 45 publications

References 87 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 treatment of chronic pancreatitis in pediatric population: Long‐term efficacy and safety

Acute Pancreatitis;

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