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Age-associated outcomes of ERCP in pediatric chronic pancreatitis

Yu Zhu1, Tianao Zhang1, Sheng Ding1

  • 1Department of Gastroenterology, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.

Pediatric Research
|August 7, 2026
PubMed

Insights

Endoscopic retrograde cholangiopancreatography (ERCP) is feasible for pediatric chronic pancreatitis, with age influencing pain relief and post-ERCP pancreatitis (PEP) risk. School-aged children experienced better pain relief, while younger children had higher PEP rates.

Area of Science:

  • Pediatric Gastroenterology
  • Interventional Endoscopy
  • Clinical Nutrition

Background:

  • Pediatric chronic pancreatitis (CP) presents significant morbidity and nutritional challenges.
  • The impact of endoscopic retrograde cholangiopancreatography (ERCP) on clinical and nutritional outcomes in children with CP is not well-defined.

Purpose of the Study:

  • To evaluate age-associated clinical and nutritional outcomes following ERCP in pediatric patients with chronic pancreatitis.
  • To assess the safety and efficacy of ERCP in this population.

Main Methods:

  • Retrospective cohort study of 154 pediatric patients undergoing 360 ERCP procedures (2019-2024).
  • Age-stratified analyses were performed.
  • Primary outcomes included pre-discharge pain relief (VAS <4), post-ERCP pancreatitis (PEP) incidence, and body mass index (BMI) changes. Nutritional status was assessed via BMI, weight-for-age Z-scores, and vitamin D levels.

Main Results:

  • ERCP technical success rate was 99.17%.
  • High rates of nutritional abnormalities were noted: vitamin D deficiency (61.2%), undernutrition (18%).
  • PEP occurred in 30.8% of procedures, with higher incidence in preschool-aged children (35.13%) vs. school-aged children (27.8%). School-aged children demonstrated better pain relief and BMI trends.

Conclusions:

  • ERCP is technically feasible in pediatric CP with generally mild complications.
  • Age significantly impacts ERCP outcomes, with differences in pain relief and PEP risk observed between preschool-aged and school-aged children.
  • Findings suggest the need for age-specific risk assessment and individualized nutritional follow-up post-ERCP.
Abstract

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