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Gestión basada en ERCP de la pancreatitis crónica pediátrica: Resultados de un estudio multicéntrico retrospectivo a
Simona Faraci1, Giovanni Rollo1, Federico Alghisi2
1Gastroenterology and nutrition Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
Resumen
La colangiopancreatografía endoscópica retrógrada (ERCP) reduce efectivamente los episodios de pancreatitis aguda en niños con pancreatitis crónica. Este procedimiento puede mejorar su calidad de vida al disminuir la recurrencia de los síntomas.
Área de la Ciencia:
- Gastroenterología Pediátrica Gastroenterología pediátrica
- La endoscopia intervencionista también se utiliza.
Sus antecedentes:
- La pancreatitis crónica (PC) en niños conduce a episodios agudos recurrentes y disfunción pancreática progresiva.
- La colangiopancreatografía endoscópica retrógrada (ERCP) se utiliza para el manejo de problemas ductales en la parálisis cerebral, pero la evidencia pediátrica es escasa.
Objetivo del estudio:
- Evaluar la eficacia y seguridad del tratamiento basado en ERCP para pacientes pediátricos con PC genéticamente asociada.
- Evaluar el impacto de ERCP en las tasas de recurrencia de pancreatitis en esta población.
Principales métodos:
- Un estudio retrospectivo multicéntrico incluyó a niños con PC genéticamente asociada sometidos a ERCP.
- Se recopilaron y compararon datos sobre procedimientos clínicos, resultados y tasas de incidencia de pancreatitis antes y después del ERCP.
Principales resultados:
- Cuarenta y dos pacientes pediátricos se sometieron a ERCP, con una media de 4,5 procedimientos cada uno.
- ERCP redujo significativamente los episodios de pancreatitis aguda (PIRpre 4.6 frente a PIRpost 1.1, p = 0.0024), independientemente de la colocación del stent.
- La pancreatitis post-ERCP (PEP) se produjo en el 14,2% de los procedimientos, en su mayoría leves; las complicaciones fueron raras y administradas de manera conservadora.
Conclusiones:
- ERCP es un tratamiento seguro y eficaz para reducir la recurrencia de la pancreatitis en niños con PC genéticamente asociada.
- Los hallazgos sugieren que el ERCP puede potencialmente mejorar la calidad de vida de estos pacientes jóvenes.
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