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Endoscopic Management of Chronic Pancreatitis in Children: A Single-center Experience Over a Decade
Malla Va Gangadhar Rao1, Ujjal Poddar2, S Rakesh Kumar1
1Department of Gastroenterology.
Insights
Endoscopic retrograde cholangiopancreatography (ERCP) effectively manages pediatric chronic pancreatitis (CP), offering pain relief and stabilizing exocrine/endocrine functions. This safe procedure shows high success rates in children, with manageable complications.
Area of Science:
- Pediatric Gastroenterology
- Interventional Endoscopy
Background:
- Chronic pancreatitis (CP) management in adults is established with ERCP.
- Limited data exists on ERCP's efficacy in pediatric CP cases.
- This study evaluates ERCP for pain relief and its impact on insufficiency in children.
Purpose of the Study:
- To assess the success, safety, and effectiveness of therapeutic ERCP in children with CP.
- To determine ERCP's impact on pain, exocrine, and endocrine insufficiency in pediatric patients.
- To provide data on ERCP outcomes for a critical pediatric condition.
Main Methods:
- Retrospective analysis of a prospectively maintained database (2010-2020).
- Included children (≤18 years) with CP undergoing therapeutic ERCP.
- Data collected on clinical details, investigations, procedures, and follow-up.
Main Results:
- 65 children (mean age 12.8 years) were analyzed; 69% idiopathic CP.
- High technical (95.3%), endoscopic (92.3%), and clinical (85.6%) success rates.
- Significant pain relief, non-progression of insufficiency, and low complication rate (6.1%) observed post-ERCP.
Conclusions:
- Therapeutic ERCP is safe and effective for pediatric CP.
- ERCP significantly improves pain and stabilizes exocrine/endocrine functions in children.
- Repeat ERCP successfully managed symptom recurrence in 10% of cases.
Background:
Chronic pancreatitis (CP) complications in adults are successfully managed with endoscopic retrograde cholangiopancreatography (ERCP). Data are limited on the success of ERCP in children with CP. We reviewed our experience to ascertain the success, safety, and effectiveness of ERCP for relieving pain and its effect on exocrine and endocrine insufficiency.
Methods:
Retrospective analysis of a prospectively kept database of children (≤18 y) with CP who underwent therapeutic ERCP between 2010 and 2020 was reviewed. Clinical details, laboratory and radiologic investigations, procedural details, and follow-up data were retrieved from manual and electronic records. Categorical and numerical data were expressed as proportion and mean ± SD.
Results:
Sixty-five children (60% males), age 12.8 ± 2.9years, were included. The most common etiology was idiopathic (n = 45, 69%). Technical, endoscopic, and clinical success rates were 95.3%, 92.3%, and 85.6%, respectively. Only 4 patients (6.1%) had major complications. Over a median follow-up of 24 months, therapeutic ERCP resulted in significant pain relief, with nonprogression of exocrine and endocrine insufficiency. Recurrence of symptoms was noted in 10%, which were managed successfully with repeat ERCP.
Conclusion:
Therapeutic ERCP is a safe and effective therapy for the management of CP in children, with significant improvement in pain, and could influence stabilization of exocrine and endocrine functions.
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