Surgical and Endoscopic Intervention for Chronic Pancreatitis in Children: The Kings College Hospital Experience

Area of Science:

• Gastroenterology and Hepatology
• Pediatric Surgery
• Medical Imaging

Background:

• Paediatric chronic pancreatitis (CP) is a rare, debilitating condition.
• It often necessitates invasive diagnostic and therapeutic approaches.
• Management addresses primary causes like pancreaticobiliary malunion and secondary complications such as chronic pain.

Purpose of the Study:

• To review the diagnostic and therapeutic roles of endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic ultrasound (EUS) in pediatric CP.
• To highlight the increasing utilization of endoscopic interventions.
• To discuss the role of surgical interventions in managing CP and its complications.

Main Methods:

• Review of current literature and clinical practices regarding pediatric CP management.
• Emphasis on endoscopic techniques (ERCP, EUS) for diagnosis and therapy.
• Discussion of surgical interventions for ductal decompression and anatomical abnormalities.

Main Results:

• ERCP and EUS are established diagnostic tools in pediatric CP.
• Therapeutic applications of ERCP and EUS are gaining popularity.
• Surgical decompression effectively alleviates pancreatic duct hypertension.
• Surgery is also indicated for specific anatomical issues and complications like pseudocysts.

Conclusions:

• Endoscopic modalities (ERCP, EUS) are crucial in diagnosing and treating pediatric CP.
• Surgical interventions remain vital for specific complications and anatomical corrections.
• A multidisciplinary approach integrating endoscopic and surgical techniques optimizes outcomes for pediatric CP patients.