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Therapeutic step-up strategy for management of hereditary pancreatitis in children

S Kargl1, M Kienbauer2, H C Duba3

  • 1Department of Pediatric Surgery, Women's and Children's Hospital Linz.

Journal of Pediatric Surgery
|April 4, 2015
PubMed

Insights

A step-up treatment plan using early endoscopic retrograde cholangiopancreatography (ERCP) and surgery effectively manages hereditary pancreatitis in children, preventing recurrence and ensuring a normal quality of life.

Area of Science:

  • Pediatric Gastroenterology
  • Hereditary Pancreatitis Treatment
  • Minimally Invasive Surgery

Background:

  • Hereditary pancreatitis in childhood presents diverse treatment challenges.
  • Current therapeutic options require a structured approach.

Purpose of the Study:

  • To propose and evaluate a therapeutic pathway for childhood hereditary pancreatitis.
  • Emphasis on integrating endoscopic and surgical interventions.

Main Methods:

  • Prospective inclusion of 12 pediatric patients with hereditary pancreatitis (2006-2013).
  • Implementation of a therapeutic step-up schema involving diagnostic work-up and interventions.
  • Evaluation of treatment outcomes correlated with etiological factors and pathoanatomic findings.

Main Results:

  • Early endoscopic retrograde cholangiopancreatography (ERCP) was successful in 10 of 12 patients.
  • Eight patients with obstructive pancreatitis required sphincterotomy, dilation, and stenting.
  • Open surgical drainage was performed for two patients with unsuccessful ERCP.
  • After a mean 32-month follow-up, all patients were free of pancreatitis recurrence.

Conclusions:

  • A step-plan approach with early ERCP is effective for hereditary pancreatitis in children.
  • Open surgical drainage is a viable option for cases with impossible or insufficient endoscopic treatment.
  • This strategy prevents recurrent pancreatitis and ensures a normal quality of life with minimal complications.
Abstract

Keywords:
Endoscopic retrograde cholangiopancreatographyHereditary pancreatitisPancreatic surgery

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